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Eldon L. Foltz and David B. Shurtleff

(PSP). 3 In 2 instances it was felt we had clear x-ray evidence of ependymal trauma from a ventricular catheter which had been placed against the wall of the ventricle. In 2 cases collapse and “corrugating” of the ventricular wall occurred secondary to resolution of the ventriculomegaly by a functioning ventriculo-atrial shunt ( Fig. 2 ). In 5 patients, infections were prominent during this interval. Three children had septicemia, and 2 of these had cells in the ventricular fluid suggesting a ventriculitis, though an active infection was not proven. In 2 other

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James R. Atkinson, David B. Shurtleff and Eldon L. Foltz

intracranial pressure by radio telemetry. We wished particularly to measure the cerebrospinal fluid ventricular pressure wave form and study its relationship to the ventriculomegaly of hydrocephalus. The method is also applicable to the study of mean intracranial pressure in problems of intracranial mass lesions. Biological safety and physical limitations of materials and design must, however, be recognized as limiting factors in the development of transensors for human use. Materials and Methods The transensor developed for neurosurgical use combines the functions of

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Thomas C. Guthrie, Howard S. Dunbar and Barbara Karpell

infants, Shulman and Ransohoff 10 postulated a loss of venting action of the venous sinus systems, as well as of the absorptive capacity of the sagittal sinus, inferring that elevated sagittal sinus pressure sometimes contributed to the development of hydrocephalus. In spite of these studies, the relationship between ventriculomegaly and chronic increased intracranial venous pressure remains unclear. We felt, therefore, that further investigation was warranted. Materials and Method Ten adult mongrel dogs weighing from 21 to 42 kg were subjected to an operation

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Fred Epstein, Gerald Hochwald and Joseph Ransohoff

repaired without difficulty shortly after admission. One week later hydrocephalus became manifest and a ventriculogram disclosed aqueductal stenosis with severe ventriculomegaly; the frontal cortical mantle was reduced to 1.5 cm. A ventriculopleural shunt with a volume control valve was inserted. In the immediate postoperative period the valve was opened for 6 minutes every 4 hours. Within 72 hours this was reduced to 2 minutes every 8 hours. On this regime the anterior fontanel remained depressed and the head circumference decreased from 37.5 to 36 cm. During the

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David B. Shurtleff, Richard Kronmal and Eldon L. Foltz

instance, mucopolysaccharidosis). Inactive Untreated Hydrocephalus The condition of patients with ventriculomegaly, low pressure, and a static or normal head growth rate was considered arrested; 17, 30 these patients were not assigned to operative or nonoperative groups unless the hydrocephalus became progressive. There were 106 such patients with myelodysplasia and inactive or clinically insignificant hydrocephalus. 19, 21, 30 The critical difference between these 106 patients and the previous two groups was the absence of progressing hydrocephalus

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dilatation in the hydrocephalic cat with a hemicraniectomy 3 may not be in any way analogous to occasional ventriculomegaly beneath a “growing skull fracture.” In the latter situation there may be associated injury to the brain causing local porencephaly and hydrocephalus ex-vacuo. In the laboratory, hemicraniectomy and dural excision in cats does not cause ventricular dilatation unless there is associated obstructive hydrocephalus. Therefore, it is not only “dural and osseous continuity” which is of importance in preventing ventricular enlargement. Subtemporal

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Thomas H. Milhorat, Mary K. Hammock, Techen Chien and Donald A. Davis

lateral ventricle choroid plexuses for hydrocephalus in our clinic. An opportunity was afforded to measure the rate of CSF formation when the patient presented 5 years later with a failed ventriculoperitoneal shunt and evidence of progressive ventriculomegaly on serial cranial computed tomography (CCT) scans. Case Report A 3-week-old baby boy with meningitis and ventriculitis developed severe communicating hydrocephalus ( Fig. 1 ). In spite of systemic antibiotics, the ventriculitis persisted and the head circumference increased at a rate of 2 cm per week. In July

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Kenneth Shapiro and Kenneth Shulman

inconstant. Bering and Salibi 3 occluded all accessible pathways of intracranial venous outflow, obtaining sustained periods of intracranial venous hypertension and producing ventriculomegaly in 74% of animals. More recently Guthrie, et al., 10 used torcular blockade to study the effects of increased venous pressure on ventricular size. Despite production of chronic elevations of CSFP and superior sagittal sinus pressure (SSVP) torcular blockade did not result in ventricular enlargement. Radical neck dissection, superior vena cava syndrome, and dural venous sinus

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L. Dade Lunsford, Joseph C. Maroon, William O. Bank, Burton P. Drayer and Arthur E. Rosenbaum

convergence, and papilledema. Cranial computerized tomography (CT) soon after admission demonstrated ventriculomegaly and a mass in the region of the posterior third ventricle. No hematoma was visualized. A right frontal ventriculoperitoneal shunt was inserted. Thereafter her mental status improved, but profound impairment of recent memory persisted. To localize the AVM more precisely before intracranial surgery, combined metrizamide ventriculography and stereoscopic retrograde transfemoral angiography were performed simultaneously. Through a No. 23 needle, 7 cc of

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Joan L. Venes, Bennett A. Shaywitz and Dennis D. Spencer

cerebral perfusion pressure was not a problem. Monitoring was discontinued 8 days later following which he was noted to be profoundly hypotonic. He improved slowly, and with restoration of normal muscle tone it was apparent that he had a significant right hemiparesis. In addition he was felt to have a global aphasia. Computerized tomography demonstrated ventriculomegaly and evidence of diffuse cerebral atrophy. He continues to make slow progress with resolution of hemiparesis and return of speech and understanding. At present he is felt to be suffering from an organic