Herbal prescription Siryeongtang and acupuncture treatment for gait disturbance due to idiopathic normal pressure hydrocephalus: A case report.

Background: Idiopathic normal-pressure hydrocephalus (iNPH), characterized by unexplained normal-pressure hydrocephalus, primarily presents with symptoms such as gait disturbances, cognitive impairment, and urinary incontinence. Currently, cerebrospinal fluid (CSF) drainage via shunting is the only effective treatment for iNPH.

Case Presentation: A 56-year-old Asian woman visited our hospital with a worsening gait disturbance and a history of recurrent falls over the past 2 years.

Long-term evaluation of neurological outcomes in chemotherapy-associated posterior reversible encephalopathy (PRES) syndrome in children.

Background: Posterior reversible encephalopathy syndrome (PRES) is a clinical syndrome with numerous etiologies, mostly characterized by magnetic resonance imaging (MRI) abnormalities in the posterior cerebral white and gray matter and acute neurological symptoms.

Aim: To examine the predisposing factors, clinical results, and radiological features of PRES in children diagnosed with malignancy.

Materials And Methods: The study included 20 patients (7 F/13 M) aged 4-16 years at the time of diagnosis who were diagnosed with malignancy and developed PRES during chemotherapy.

The extreme lateral transodontoid approach for large tumors in children in the ventral craniocervical junction.

Objective: Tumors in the ventral craniocervical junction (CCJ) pose unique challenges, particularly in children. The potential constraints with endoscopic approaches to tumors extending inferiorly and laterally and the risk of CSF leakage can be exacerbated in the pediatric population. Here, the authors present their experience with the extreme lateral transodontoid (ELTO) approach in children with large ventral CCJ tumors as an alternative or complement to anterior approaches.

Tubular single-port endoscope-assisted surgery for fetal myelomeningocele repair.

Objective: The authors aimed to describe a low-cost and easily reproducible alteration of the Bruner and Tulipan procedure to preserve uterine muscular fibers. They conducted a retrospective cohort study of 10 pregnant women whose fetuses developed lumbosacral myelomeningocele (MM). The MM was repaired through a fetal neurosurgical procedure using a tubular single-port endoscope-assisted technique.

A Systematic Review of Human Paenibacillus Infections and Comparison of Adult and Pediatric Cases.

Background: Neonatal infections due to Paenibacillus species have increasingly been reported over the last few years.

Methods: We performed a structured literature review of human Paenibacillus infections in pediatric and adult patients to compare the epidemiology of infections between these distinct patient populations.

Results: Forty reports describing 177 infections were included.

Free-hand Frameless Pinless Electromagnetic-Navigation (AXIEM™)-Guided Brain Lesion Biopsies: An Institution Based Experience from a Low-Middle-Income Country.

Objectives: To evaluate the precision and safety of a novel technique of free-hand frameless pinless AXIEM™-based navigation guided biopsy of deep-seated brain lesions in a low-middle income country.

Methods: This retrospective study included 45 patients who underwent free-hand frameless pinless AXIEM™-based navigation guided biopsy of deep-seated brain lesions using the Medtronic-Stealth S7 system over a 5-year period (January 2019 to December 2023) at the Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan.

Results: A total of 45 patients were included in this study.

Radiometric and Morphologic Analysis of Arnold Chiari Type-I Malformation and Idiopathic Syringomyelia: A Case Series from Pakistan.

Background And Objective: Chiari I Malformation-associated syringomyelia (CM) and idiopathic syringomyelia (IS) are often confused together. They require different diagnostic approach and treatment modalities; it is important to distinguish between the two. We aimed to evaluate the radiological and morphologic characteristics of CM and IS in adult and pediatric patients in Pakistani population.

Outcomes of Fenestration of Lamina Terminalis for Hydrocephalus following Clipping of Ruptured Aneurysms of Anterior Circulation.

Objectives: To evaluate the Outcomes of Fenestration of Lamina Terminalis for Hydrocephalus following Clipping of Ruptured Aneurysms of Anterior Circulation.

Methods: A retrospective case series study was conducted at the Punjab Institute of Neurosciences, Lahore from August 2022 to July 2023. Seventy seven patients meeting the inclusion criteria of age group 20-65 years, ruptured saccular aneurysm of anterior circulation with or without lamina terminalis fenestration during clipping, were enrolled through non-probability convenience sampling.

Double encephalocele in a four-year-old girl: A case report with literature review.

Encephalocele is a congenital neural tube defect (NTD). The pathophysiology of the NTDs is exceedingly complex. Numerous explanations have been proposed to explain it.

Surgical outcome of clipping in anterior circulation aneurysms.

Objective: To observe the outcome of surgical clipping in anterior circulation aneurysm in a modestly resourced hospital.

Methods: A retrospective cross-sectional study was conducted at Punjab Institute of Neurosciences Lahore, from August 2022 to July 2023. Seventy five patients meeting the inclusion criteria of age <65, saccular aneurysm of anterior circulation, and Hunt and Hess grade one or two were enrolled through non-probability convenience sampling.

Endoscopic third ventriculostomy with or without choroid plexus cauterization for preventing shunt dependence in pediatric hydrocephalus: preliminary results of a prospective clinical case series in a lower-middle-income country (Egypt).

Purpose: Pediatric hydrocephalus imposes a significant clinical and financial burden in developing countries. Traditional treatment by ventricular shunting in this setting suffers a high rate of shunt infection and malfunction. This study aims at assessing the efficacy and safety of endoscopic third ventriculostomy (ETV), either alone or combined with choroid plexus cauterization (CPC), for preventing shunt dependence in pediatric hydrocephalus within a healthcare setting of a tertiary hospital in Egypt.

In response to Mutti et al. 2024 commentary on "Transient intracranial pressure elevations (B waves) associated with sleep apnea: the neglected role of cyclic alternating pattern".

The physiology of transient intracranial pressure (ICP) elevations (B waves), remains incompletely understood and appears to involve multiple mechanisms, including obstructive sleep apnea (OSA). Transient ICP elevations are associated with OSA and cyclic alternating pattern (CAP) metrics, suggesting a complex interplay between sleep fragmentation and ICP dynamics. Additionally, CAP metrics could complement standard OSA assessments, providing deeper insights into transient ICP fluctuations, particularly in conditions like normal-pressure hydrocephalus and idiopathic intracranial hypertension.

Recapitulation of physiologic and pathophysiologic pulsatile CSF flow in purpose-built high-throughput hydrocephalus bioreactors.

Background: Hydrocephalus, an accumulation of cerebrospinal fluid (CSF) in the ventricles of the brain, is often treated via a shunt system to divert the excess CSF to a different compartment; if left untreated, it can lead to serious complications and permanent brain damage. It is estimated that one in every 500 people are born with hydrocephalus. Despite more than 60 years of concerted efforts, shunts still have the highest failure rate of any neurological device requiring follow-up shunt revision surgeries and contributing to the $2 billion cost of hydrocephalus care in the US alone.

Intracranial complications in adult patients with severe pneumococcal meningitis: a retrospective multicenter cohort study.

Background: We aimed to investigate the association of intracranial complications diagnosed on neuroimaging with neurological outcomes of adults with severe pneumococcal meningitis.

Methods: We performed a retrospective multicenter study on consecutive adults diagnosed with pneumococcal meningitis requiring at least 48 h of stay in the intensive care unit (ICU) and undergoing neuroimaging, between 2005 and 2021. All neuroimaging were reanalyzed to look for intracranial complications which were categorized as (1) ischemic lesion, (2) intracranial hemorrhage (3) abscess/empyema, (4) ventriculitis, (5) cerebral venous thrombosis, (6) hydrocephalus, (7) diffuse cerebral oedema.

Reconstructive endovascular treatment of patients with ruptured distal intracranial aneurysms in posterior circulation: a retrospective cohort study.

Background: Cases of ruptured distal intracranial aneurysms (DIAs) in the posterior circulation are rare. Currently, the most commonly used approach in clinical practice to treat this condition is reconstructive endovascular treatment. However, research on endovascular treatment of intracranial posterior circulation ruptured DIAs is currently lacking.

A case report of mental disorder caused by shunt blockage after hydrocephalus surgery.

Introduction: Hydrocephalus is a form of communication hydrocephalus syndrome characterized by ventricular enlargement and normal intraventricular pressure. The primary clinical manifestations include gait disturbances, cognitive dysfunction, urinary incontinence, and either elevated or normal intracranial pressure. This paper presents a case of a mental disorder resulting from inadequate drainage following a ventriculoperitoneal shunt procedure for hydrocephalus.

Ischemic and Hemorrhagic Brain Damage in Methanol Poisoning: A Case of Rapid Deterioration.

BACKGROUND Methanol is a toxic alcohol that is often ingested accidentally or intentionally. Its metabolites can induce severe visual disturbances, metabolic acidosis, and neurological dysfunction, which can frequently become life-threatening. CASE REPORT A 44-year-old woman with a history of depression and alcohol use was hospitalized in the Intensive Care Unit after cardiopulmonary reanimation.

Association between choroid plexus volume and cognitive function in community-dwelling older adults without dementia: a population-based cross-sectional analysis.

Background: An increase in choroid plexus (CP) volume may be associated with cognitive decline in older individuals without dementia. In this study, we aimed to clarify whether CP volume can serve as an imaging marker of cognitive decline, determine how strongly CP volume is associated with cognitive decline, and explore factors associated with CP volume in older adults.

Methods: We measured CP volume, brain parenchyma, and cerebrospinal fluid (CSF) spaces associated with disproportionately enlarged subarachnoid space hydrocephalus (DESH), an imaging feature of normal-pressure hydrocephalus, in community-dwelling older adults aged ≥ 65 years without dementia.

A novel minimally invasive neurosurgical cranial fixation device for improved accuracy of intraventricular catheter placement: an experimental animal study.

Background: External ventricular drain (EVD) insertion is one of the most commonly performed neurosurgical procedures. Herein, we introduce a new concept of a cranial fixation device for insertion of EVDs, that reduces reliance on freehand placement and drilling techniques and provides a simple, minimally invasive approach that provides strong fixation to minimal thickness skulls.

Methods: An experimental device for catheter insertion and fixation was designed and tested in both ex-vivo and in-vivo conditions to assess accurate cannulation of the ventricle and to test the strength of fixation to the skull.

Successful endoscopic third ventriculostomy in a patient with 40 years of ventriculoperitoneal shunt dependency since infancy: a case report.

Ventriculoperitoneal shunt malfunction is a common complication in patients with lifelong hydrocephalus. We present a case of a 40-year-old man who successfully underwent endoscopic third ventriculostomy (ETV) for shunt malfunction following neonatal meningitis. Despite long-term shunt dependency and an infectious etiology, ETV effectively managed his hydrocephalus, probably due to aqueductal stenosis and preserved cerebrospinal fluid absorption.

The Na,K,2Cl Cotransporter, Not Aquaporin 1, Sustains Cerebrospinal Fluid Secretion While Controlling Brain K Homeostasis.

Disturbances in the brain fluid balance can lead to life-threatening elevation in intracranial pressure (ICP), which represents a vast clinical challenge. Targeted and efficient pharmaceutical therapy of elevated ICP is not currently available, as the molecular mechanisms governing cerebrospinal fluid (CSF) secretion are largely unresolved. To resolve the quantitative contribution of key choroid plexus transport proteins, this study employs mice with genetic knockout and/or viral choroid plexus-specific knockdown of aquaporin 1 (AQP1) and the Na, K, 2Cl cotransporter 1 (NKCC1) for in vivo determinations of CSF dynamics, ex vivo choroid plexus for transporter-mediated clearance of a CSF K load, and patient CSF for [K] quantification.

Novel insights into non-coding RNAs and their role in hydrocephalus.

A large body of evidence has highlighted the role of non-coding RNAs in neurodevelopment and neuroinflammation. This evidence has led to increasing speculation that non-coding RNAs may be involved in the pathophysiological mechanisms underlying hydrocephalus, one of the most common neurological conditions worldwide. In this review, we first outline the basic concepts and incidence of hydrocephalus along with the limitations of existing treatments for this condition.

Chronic vomiting revealing Joubert syndrome: A case report.

Joubert syndrome is a rare autosomal recessive disorder characterized by the presence of the molar tooth sign on imaging. We report the case of a 5-year-old girl diagnosed with Joubert syndrome during the investigation of chronic vomiting. The patient presented with neuropsychomotor delay, a history of neonatal respiratory disorders, and hydrocephalus treated with a ventriculoperitoneal shunt.