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Establishing ranked priorities for future hydrocephalus research

Noriana E. Jakopin, Elliot Myong, Trish Bogucki, Diana Gray, Paul Gross, J. Gordon McComb, Chevis N. Shannon, Mandeep S. Tamber, Maiko Toyama, Tessa van der Willigen, Amir Yazdani, Mark G. Hamilton, and Jenna E. Koschnitzky

H ydrocephalus is a complex, chronic condition that occurs due to an imbalance between CSF production and absorption within the brain. Hydrocephalus can affect anyone at any age, and the patient population is diverse, including individuals with congenital hydrocephalus; children and adults who develop hydrocephalus due to injury, infection, hemorrhage, or brain tumor; and older adults who develop idiopathic normal pressure hydrocephalus (iNPH). There is currently no successful medical treatment for hydrocephalus, despite its prevalence. 1 – 6 The only

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Hydrocephalus research funding from the National Institutes of Health: a 10-year perspective

Clinical article

Paul Gross, Gavin T. Reed, Rachel Engelmann, and John R. W. Kestle

H ydrocephalus affects at least 1 in 1000 live newborns, and the cost of hydrocephalus in terms of both health care dollars and quality of life is significant. 2 In 2003 there were 39,900 admissions, 433,000 hospital days and $2 billion in charges for pediatric hydrocephalus. Clinical research into the condition is largely the domain of neurosurgeons, who rarely have sufficient protected time to conduct meaningful work. Basic science investigators in hydrocephalus are a rare breed with limited resources and a small peer group that has not grown over the

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What we don’t (but should) know about hydrocephalus

Marvin Bergsneider, Michael R. Egnor, Miles Johnston, Dory Kranz, Joseph R. Madsen, James P. Mcallister II, Curt Stewart, Marion L. Walker, and Michael A. Williams

The problem isn’t with what we don’t know, the problem is with what we do know that isn’t so. —WILL ROGERS Hardly any other pathological condition has been accorded more determined attention on the part of the medical profession . . . than has hydrocephalus. And in hardly a single other condition have cures been so elusive or so often wrecked on purely mechanical obstacles. —LEO DAVIDOFF, 1929 4 Barely 25 years after Davidoff decried the lack of a cure for hydrocephalus, effective shunts came into existence. Since then, thousands of children

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An update on research priorities in hydrocephalus: overview of the third National Institutes of Health-sponsored symposium “Opportunities for Hydrocephalus Research: Pathways to Better Outcomes”

James P. McAllister II, Michael A. Williams, Marion L. Walker, John R. W. Kestle, Norman R. Relkin, Amy M. Anderson, Paul H. Gross, and Samuel R. Browd

A s reported in the priorities from the 2005 National Institutes of Health (NIH) hydrocephalus workshop 133 and presented at the 2009 NIH-sponsored workshop in Baltimore, Maryland, the clinical and scientific perspective of hydrocephalus has shifted from the oversimplified view of hydrocephalus as a “plumbing problem” that is adequately managed with a shunt to that of an exceptionally complex, multifactorial disorder that involves novel and poorly understood injury and recovery mechanisms. The white paper generated from the 2005 NIH hydrocephalus

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Hydromyelic hydrocephalus

Correlation of hydromyelia with various stages of hydrocephalus in postshunt isolated compartments

Shizuo Oi, Hiroshi Kudo, Hiroshi Yamada, Songyu Kim, Seiji Hamano, Seishiro Urui, and Satoshi Matsumoto

-Robin spaces; 4 transmedullary passage of CSF; 1 development of an Arnold-Chiari malformation due to a negative pressure gradient; 48 and central cord necrosis induced by impaired venous drainage. 46 Although it is well known that the neural tube is primarily a single cavity in its early stages of development and that fetal hydrocephalus is often associated with hydromyelic central canal dilatation (hydrocephalomyelia 18 ), few studies have correlated the pathophysiology of hydromyelia with changes in associated hydrocephalus, including postshunting cases. This study

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Inpatient healthcare burden and variables influencing hydrocephalus-related admissions across the lifespan

Jenna E. Koschnitzky, Erwin Yap, Yifan Zhang, Monica J. Chau, Ketan Yerneni, Anna Lisa Somera, Mark Luciano, and Abhay Moghekar

H ydrocephalus is a significant medical and financial burden to the healthcare system. The mainstay treatment involves CSF diversion via surgical shunt placement, with more than 30,000 procedures performed annually in the US. 1 However, shunts are plagued with high failure rates, which can lead to significant morbidity and mortality. In fact, > 28% of shunt recipients require revision surgery in the 1st year. 2 , 3 The financial burden of hydrocephalus is immense and has been well characterized, along with hydrocephalus etiologies and perioperative

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Posthemorrhagic hydrocephalus

Low incidence in very low birth weight neonates with intraventricular hemorrhage

Laura R. Ment, Charles C. Duncan, David T. Scott, and Richard A. Ehrenkranz

I ntraventricular hemorrhage (IVH), or hemorrhage into the germinal matrix tissues (GMH) of the developing brain, is a major problem of preterm neonates; over 40% of infants with birth weights less than 1500 gm have been found to experience either or both disorders (GMH/IVH). 4, 9, 16, 25, 27, 31, 35 In addition to seizures and long-term neurodevelopmental handicaps, infants with IVH are at risk for posthemorrhagic hydrocephalus (PHH). 10, 18, 27, 37 The hydrocephalus is generally believed secondary to obliterative posterior fossa arachnoiditis which is

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Management of intrauterine hydrocephalus

David D. Cochrane and S. Terence Myles

–152, 1976 10.1016/0002-9378(76)90266-0 11. Freeman RK , McQuown DS , Secrist LJ , et al : The diagnosis of fetal hydrocephalus before viability. Obstet Gynecol 49 : 109 – 112 , 1977 Freeman RK, McQuown DS, Secrist LJ, et al: The diagnosis of fetal hydrocephalus before viability. Obstet Gynecol 49: 109–112, 1977 12. Garrett WJ , Fisher CC , Kossoff G : Hydrocephaly, microcephaly and anencephaly diagnosed in pregnancy by ultrasonic echography. Med J Aust 2 : 587 – 589 , 1975

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External hydrocephalus in adults

Report of three cases

érico R. Cardoso and Romaine Schubert

T he clinical entity known as external hydrocephalus is well recognized in infants. Symptomatic external hydrocephalus has not yet been described in adults. We report three adult patients who developed symptomatic extraaxial fluid collections following intracranial hemorrhage. Case Reports Case 1 This 53-year-old normotensive man presented with a 1-day history of occipital headache and photophobia. Examination The patient's neurological examination was normal with the exception of mild stiff neck. He had mild leukocytosis and hyponatremia

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Improving health care transition and longitudinal care for adolescents and young adults with hydrocephalus: report from the Hydrocephalus Association Transition Summit

Michael A. Williams, Tessa van der Willigen, Patience H. White, Cathy C. Cartwright, David L. Wood, and Mark G. Hamilton

P ediatric hydrocephalus is a significant population health issue in the US, with nearly 40,000 annual hospital admissions and associated hospital charges estimated at US$1.4–2.0 billion in 2008. 31 The health care needs of this population continue beyond childhood and adolescence; however, pediatric hospitals and pediatric neurosurgeons are often unable to provide care to these patients once they become adults. Each year in the US, an estimated 5000–6000 adolescents and young adults (collectively, youth) with congenital or acquired hydrocephalus ( https