Research priorities for improving cognitive and neuropsychological outcomes in hydrocephalus.

Hydrocephalus is a neurological disorder that impacts approximately 85 per 100,000 individuals worldwide and is associated with motor and cognitive impairments. While many advances in surgical interventions have helped substantially improve the survival rates and quality of life of those affected, there continues to be significant gaps in our understanding of the etiology of this heterogeneous condition as well as its specific neuropsychological and functional challenges across different phases of life. To address these limitations, the Hydrocephalus Association and Rudi Schulte Research Institute organized a workshop titled, "Improving Cognitive and Psychological Outcomes in Hydrocephalus", composed of top academics in the fields of hydrocephalus, cognition, and neuropsychology, as well as individuals with hydrocephalus or their caregivers.

Continuous quantitative electroencephalography for early detection of acute low-pressure obstructive hydrocephalus in aneurysmal subarachnoid hemorrhage: illustrative case.

Background: Aneurysmal subarachnoid hemorrhage (aSAH) is often associated with acute high-pressure hydrocephalus. Less commonly, an acute low-pressure hydrocephalus (ALPH) variant can develop and contribute to increased morbidity. ALPH is particularly challenging to diagnose and manage, as patients present with symptoms of increased intracranial pressure (ICP) despite the absence of corroborating evidence from ICP measurements.

Early postoperative lumbar catheter severing in a lumboperitoneal shunt due to bite-off by the spinous processes following a fall on the buttocks: illustrative case.

Background: Rupture of the lumbar catheter in lumboperitoneal (LP) shunts is rare and typically occurs due to long-term mechanical stress. The authors describe an unusual case of early postoperative lumbar catheter severing after a fall on the buttocks.

Observations: A 78-year-old woman underwent LP shunt placement for communicating hydrocephalus after aneurysmal subarachnoid hemorrhage.

Systematic follow-ups were not associated with reduced acute ventriculoperitoneal shunt dysfunction in infancy.

Aim: Hydrocephalus surgery with a ventriculoperitoneal shunt is a life-saving treatment, but it has been associated with a high risk of dysfunction and complications. We investigated whether infants who received a ventriculoperitoneal shunt below 12 months of age had a reduced risk of acute shunt dysfunction if they were included in a structured follow-up programme.

Methods: A population-based, retrospective chart review was performed at Uppsala University Children's Hospital, Sweden.

Progressive histological and behavioral deterioration of a novel mouse model of secondary hydrocephalus after subarachnoid hemorrhage.

Hydrocephalus commonly occurs after subarachnoid hemorrhage (SAH) and is associated with increased morbidity and disability in patients with SAH. Choroid plexus cerebrospinal fluid (CSF) hypersecretion, obliterative arachnoiditis occluding the arachnoid villi, lymphatic obstruction, subarachnoid fibrosis, and glymphatic system injury are considered the main pathological mechanisms of hydrocephalus after SAH. Although the mechanisms of hydrocephalus after SAH are increasingly being revealed, the clinical prognosis of SAH still has not improved significantly.

Real-Time 2D Phase-Contrast MRI to Assess Cardiac- and Respiratory-Driven CSF Movement in Normal Pressure Hydrocephalus.

Background And Purpose: In idiopathic normal pressure hydrocephalus (iNPH) patients, cerebrospinal fluid (CSF) flow is typically evaluated with a cardiac-gated two-dimensional (2D) phase-contrast (PC) MRI through the cerebral aqueduct. This approach is limited by the evaluation of a single location and does not account for respiration effects on flow. In this study, we quantified the cardiac and respiratory contributions to CSF movement at multiple intracranial locations using a real-time 2D PC-MRI and evaluated the diagnostic value of CSF dynamics biomarkers in classifying iNPH patients.

The utility of customised tissue probability maps and templates for patients with idiopathic normal pressure hydrocephalus: a computational anatomy toolbox (CAT12) study.

Background: Disproportionately enlarged subarachnoid space hydrocephalus (DESH) is one of the neuroradiological characteristics of idiopathic normal pressure hydrocephalus (iNPH), which makes statistical analyses of brain images difficult. This study aimed to develop and validate methods of accurate brain segmentation and spatial normalisation in patients with DESH by using the Computational Anatomy Toolbox (CAT12).

Methods: Two hundred ninety-eight iNPH patients with DESH and 25 healthy controls (HCs) who underwent cranial MRI were enrolled in this study.

Atypical Variants of Spinal Dysraphism: A Case Series.

The aim of this study is to present and discuss atypical instances of spina bifida (SB) within a Nigerian paediatric cohort, highlighting their distinctive clinicoradiological features. Additionally, a brief literature review is provided to contextualise these congenital anomalies. This series comprises eight rare cases of SB managed in a Nigerian neurosurgical facility.

Spontaneous Pneumocephalus associated with leptomeningeal glioneuronal tumor in an adult; A rare case report.

Objective: To report a rare case of otogenic tension pneumocephalus as a complication of a diffuse leptomeningeal glioneuronal tumor in a patient with a ventriculoperitoneal (V. P.) shunt.

Gait characteristics in idiopathic normal pressure hydrocephalus: a review on the effects of CSF tap test and shunt surgery.

Background: Idiopathic normal pressure hydrocephalus (iNPH) is a progressive disease characterized by disproportionate ventricular enlargement at brain imaging with gait disturbance and an increased risk of falling. Gait assessment is a key feature in the diagnosis of iNPH and characterization of post-surgical outcomes.

Research Question: How do gait parameters change 24 h after CSF tap test (CSFTT) and after ventriculoperitoneal shunt surgery?

Methods: The PRISMA guidelines were used to perform the systematic review.

The effect of temporary CSF diversion modality on shunt-dependency following aneurysmal subarachnoid hemorrhage: A nationwide assessment.

Background: Aneurysmal subarachnoid hemorrhage (aSAH) carries a high economic cost and clinical morbidity in the United States. Beyond prolonged admissions and poor post-injury functional status, there is an additional cost of chronic shunt-dependent hydrocephalus for many aSAH patients. Adjuvant lumbar drain (LD) placement has been hypothesized to promote clearance of subarachnoid blood from the cisternal space, with an ultimate effect of decreasing shunt placement rates.

International web-based survey of patients with non-hydrocephalic symptomatic pineal cysts.

Objectives: To report the results of an international patient-reported survey that adds to the growing body of evidence surrounding the role of surgery in the management of a subset of patients with non-hydrocephalic symptomatic pineal cyst.

Design: An international web-based survey of health outcomes in patients with nhSPC.

Subjects: All survey participants who self-reported a diagnosis of symptomatic pineal cyst without hydrocephalus after radiological imaging.

Evaluation of the ETV success score and its predictive value in pediatric occlusive hydrocephalus: implications for patient counseling.

Introduction: Endoscopic Third Ventriculostomy (ETV) is a well-established treatment for pediatric hydrocephalus, particularly in cases of aqueductal stenosis. The ETV Success Score (ETVSS) is a predictive tool widely used to estimate the likelihood of ETV success based on factors like age. Its accuracy, especially in infants under 3 months, is still debated.

[The effectiveness of rehabilitation measures using the drug Cortexin in children with neuropsychiatric pathology].

Objective: To evaluate the effectiveness of complex rehabilitation measures using the drug Cortexin in children with neuropsychiatric pathology during a one-year follow-up.

Material And Methods: A promising dynamic examination and treatment of 323 children with neuropsychiatric pathology from the age of 7 days to 1 year, age 3.2±1.

Liver Cirrhosis as a Predictor of Infection Risk in Patients Undergoing Ventriculoperitoneal Shunt Surgery: A Retrospective Cohort Analysis from the Taiwan National Health Insurance Research Database (NHIRD).

BACKGROUND Ventriculoperitoneal (VP) shunt surgery is a widely used procedure for managing hydrocephalus; however, postoperative infections remain a serious complication, increasing morbidity and mortality. Known risk factors include prior surgeries, steroid use, and concurrent procedures. However, the role of liver cirrhosis, a condition that compromises immune function and predisposes patients to infections, has not been fully investigated in the context of neurosurgery.

Pediatric diffuse intrinsic pontine gliomas- a prospective observational study from a tertiary care neurosurgical center.

Introduction: Diffuse intrinsic pontine glioma (DIPG) in children comprises 80% of brainstem gliomas. In 2021, 5th edition of WHO CNS tumor classification defined H3K27M altered diffuse midline gliomas (DMGs) which replaced this entity. Lesion location precludes resection and the only current option available is radiotherapy.

Ultrasound-Guided Percutaneous Puncture Combined With Continuous Pressure Dressing for Treating Subcutaneous Fluid Accumulation in the Bone Window Area After Decompressive Craniectomy.

Subcutaneous fluid accumulation in the bone window area is a common complication after decompressive craniectomy. If not promptly addressed, it may progress to serious complications such as intracranial infection and hydrocephalus, significantly affecting treatment outcomes and prognosis. However, there is currently no standardized approach for managing subcutaneous fluid accumulation.

Quantifying CSF Dynamics disruption in idiopathic normal pressure hydrocephalus using phase lag between transmantle pressure and volumetric flow rate.

Background And Purpose: Idiopathic normal pressure hydrocephalus (iNPH) is a cerebrospinal fluid (CSF) dynamics disorder as evidenced by the delayed ascent of radiotracers over the cerebral convexity on radionuclide cisternography. However, the exact mechanism causing this disruption remains unclear. Elucidating the pathophysiology of iNPH is crucial, as it is a treatable cause of dementia.

Neuroinflammatory pathways and potential therapeutic targets in neonatal post-hemorrhagic hydrocephalus.

Background: Post-hemorrhagic hydrocephalus (PHH) is a severe complication in premature infants following intraventricular hemorrhage (IVH). It is characterized by abnormal cerebrospinal fluid (CSF) accumulation, disrupted CSF dynamics, and elevated intracranial pressure (ICP), leading to significant neurological impairments.

Objective: This review provides an overview of recent molecular insights into the pathophysiology of PHH and evaluates emerging therapeutic approaches aimed at addressing its underlying mechanisms.

Non-vascular structural-related intraventricular hemorrhage: Epidemiology and literature review.

Introduction: Primary intraventricular hemorrhage (PIVH) is a rare type of hemorrhagic stroke typically associated with vascular structural abnormalities. However, little is known about the epidemiology and etiology of PIVH caused by non-vascular structural abnormalities. In this study, we aimed to clarify the etiology, clinical characteristics, and prognosis of non-vascular structural-related intraventricular hemorrhage (NVSRIVH).

"This is how we do it" Maternal and fetal anesthetic management for fetoscopic myelomeningocele repairs: the Texas Children's Fetal Center protocol.

Prenatal repair of myelomeningocele (MMC) is associated with lower rates of hydrocephalus requiring ventriculoperitoneal shunt and improved motor function when compared with postnatal repair. Efforts aiming to develop less invasive surgical techniques to decrease the risk for the pregnant patient while achieving similar benefits for the fetus have led to the implementation of fetoscopic surgical techniques. While no ideal anesthetic technique for fetoscopic MMC repair has been demonstrated, we present our anesthetic approach for these repairs, including considerations for both the pregnant patient and the fetus.

Trident Sign: The Key Magnetic Resonance Imaging Finding Distinguishing Spinal Cord Sarcoidosis From Multiple Sclerosis and Seropositive Neuromyelitis Optica Spectrum Disorder.

Spinal cord sarcoidosis, an uncommon manifestation of neurosarcoidosis, presents diagnostic and therapeutic challenges because the condition is rare and has diverse clinical manifestations that can mimic other conditions such as multiple sclerosis and neuromyelitis optica spectrum disorder. A middle-aged African American female with a history of idiopathic intracranial hypertension and hydrocephalus with ventriculoperitoneal shunt presented with progressive, predominantly left-sided gait instability, weakness, and paresthesia. Cerebrospinal fluid showed lymphocytosis, red blood cells, elevated oligoclonal bands, and elevated kappa free light chains, concerning for multiple sclerosis.