Intracranial arachnoid cysts and epilepsy in children: Should this be treated surgically? Our 29-year experience and review of the literature

xlomafota13 shared this article with you from Inoreader Intracranial arachnoid cysts and epilepsy in children: Should this be treated surgically? Our 29-year experience and review of the literature Via Sociedad Luso-Española de Neurocirugía Neurocirugia (Astur). 2021 Apr 16:S1130-1473(21)00033-6. doi: 10.1016/j.neucir.2021.03.003. Online ahead of print. ABSTRACT INTRODUCTION AND OBJECTIVE: Arachnoid cysts (ACs) are relatively frequent lesions related to different neurological symptoms, being mostly incidentally diagnosed. This study aims to clarify whether AC surgery in epileptic patients is useful in their treatment. MATERIAL AND METHODS: The patients registered in the database of the Neuropediatrics Section from May 1990 to August 2019 are analyzed retrospectively. Patients in whom the diagnosis of ACs and epilepsy coincide are studied. The location, size and number of ACs, neurological development, age at diagnosis, follow-up time, the performance of surgery on the cyst, evolution, anatomical relationship between brain electrical activity and location of AC, and type of epilepsy are analyzed. RESULTS: After analyzing the database, we found 1881 patients diagnosed with epilepsy, of which 25 had at least one intracranial AC. In 9 of the patients, cerebral or genetic pathologies were the cause of epilepsy. Of the other 16, only 2 patients showed that the type of epilepsy and the epileptogenic focus coincided with the location of the AC; one of them was surgically treated without success, and the other one remained asymptomatic without receiving medical or surgical treatment. CONCLUSIONS: Although it is necessary to design a prospective study to establish causality, the results of our research and the available literature suggest that there is no causal relationship between the presence of ACs and epilepsy. The study and treatment of these patients should be carried out in a multidisciplinary epilepsy surgery unit, without initially assuming that the AC is the cause of epilepsy. PMID:33875379 | DOI:10.1016/j.neucir.2021.03.003 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prognostic value of the pulse pressure amplitudes, time to reach the plateau and the slope obtained in the lumbar infusion test for the study of idiophatic normal pressure hydrocephalus

xlomafota13 shared this article with you from Inoreader Prognostic value of the pulse pressure amplitudes, time to reach the plateau and the slope obtained in the lumbar infusion test for the study of idiophatic normal pressure hydrocephalus Via Sociedad Luso-Española de Neurocirugía Neurocirugia (Astur). 2021 Apr 16:S1130-1473(21)00030-0. doi: 10.1016/j.neucir.2021.02.004. Online ahead of print. ABSTRACT BACKGROUND AND OBJECTIVE: To study the prognostic value of the resistance to the cerebrospinal fluid outflow (Rout) obtained in the lumbar infusion test in idiopathic normal pressure hydrocephalus (iNPH), as well as the pulse pressure amplitudes in the different periods of the test and other new variables extracted by Neuropicture® software. MATERIAL AND METHODS: Patients with ́probable iNPH́ who underwent a lumbar infusion test were retrospectively revised. The positive predictive values (PPV) of the cutoff point of the best prognostic accuracy of the Rout, the basal pulse pressure amplitude (AMP0), the pulse pressure amplitude during the first 10minutes (AMP10min), the plateau pulse pressure amplitude (AMPmes), the Rout pulse pressure amplitude (AMPRout), the time to reach the plateau (T) , and the slope until reaching the plateau were determined. Patients were categorized either as responders or non-responders. RESULTS: The study included 64 responders patients and 16 non-responders patients. The PPV of Rout> 15mmHg/ml/min was 91.7%; AMP0> 2.34mmHg: 91.3%; AMP10min>4.34mmHg: 83.3%; AMPmes>12.44mmHg: 84.6%; AMPRout>6.34mmHg: 85%; T <634seconds: 86.7%; P>0.040mmHg/sec: 96.3%. CONCLUSIONS: Rout is a valid criterion to indicate a ventricular shunt. Pulse pressure amplitudes in the different periods of the lumbar infusion test, in addition to T and P, are other variables whose positivity is indicative of shunt response and should be considered in the diagnostic protocol of the iNPH. PMID:33875381 | DOI:10.1016/j.neucir.2021.02.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Myxofibrosarcoma: Another mimicker of meningioma

xlomafota13 shared this article with you from Inoreader Myxofibrosarcoma: Another mimicker of meningioma Via Sociedad Luso-Española de Neurocirugía Neurocirugia (Astur). 2021 Apr 16:S1130-1473(21)00032-4. doi: 10.1016/j.neucir.2021.03.002. Online ahead of print. ABSTRACT Primary intracranial malignant fibrous histiocytoma (MFH), or myxofibrosarcoma, is an extremely rare condition, with only a few cases reported in the literature. We report a case of a dural-based myxofibrosarcoma in a previously healthy 42-year-old man that was initially presumed to be an atypical meningioma. The findings based on conventional and advanced magnetic resonance sequences, including diffusion-weighted imaging, perfusion weighted imaging and proton magnetic resonance spectroscopy, as well as histopathological aspects, are discussed. PMID:3387 5380 | DOI:10.1016/j.neucir.2021.03.002 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Need for head and neck repositioning to restore electrophysiological signal changes at positioning for cervical myelopathy surgery

xlomafota13 shared this article with you from Inoreader Need for head and neck repositioning to restore electrophysiological signal changes at positioning for cervical myelopathy surgery Via Sociedad Luso-Española de Neurocirugía Neurocirugia (Astur). 2021 Apr 16:S1130-1473(21)00031-2. doi: 10.1016/j.neucir.2021.03.001. Online ahead of print. ABSTRACT OBJECTIVE: To evaluate the incidence of significant intraoperative electrophysiological signal changes during surgical positioning, and to assess the effectiveness of head and neck repositioning on the restoration of signals, among patients undergoing surgery for cervical myelopathy. MATERIAL AND METHODS: We used multimodal intraoperative monitoring (somatosensory [SEP] and motor evoked potentials [MEP] and spontaneous electromyography) before and after patients' positioning in a consecutive cohort of 103 patients operated for symptomatic cervical myelopathy. Significant changes were defined as>50% attenuation in amplitude or>10% increase in latency of SEP, or abolishment or 50-80% attenuation of MEP. RESULTS: Out of 103 patients (34.9% female, median age 54.5 years) 88 underwent laminectomy (85.4%) and 15 (14.6%) anterior approach. At the time of positioning, signal alterations occurred in 44 patients (42.7%), yet only 11 patients (10.7%) showed alarming changes. Immediate neck repositioning of these resulted in complete (n=6) or partial (n=4) restoration of potentials, yielding no postoperative deficits. The patient in which signals could not be restored after repositioning resulted in added postoperative deficit. The accuracy (true positives plus true negatives) of monitoring to detect new neurological deficits was 99.0% (102/103) for the entire cohort, and 100% (11/11) for those showing significant changes at the moment of positioning. Overall, only 1 patient, with non-significant SEP attenuation, experienced a new postoperative deficit, yielding a 0.97% rate of false negatives. CONCLUSION: Among patients undergoing surgery for cervical myelopathy, 10.7% showed alarming electrophysiological signal changes at the time of positioning. Immediate repositioning of the neck re sulted in near always restoration of potentials and avoidance of added neurological damage. Complete or partial restoration of potentials after repositioning yielded no postoperative deficits. PMID:33875378 | DOI:10.1016/j.neucir.2021.03.001 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Downregulation of Caveolin-1 and Upregulation of Deiodinase 3, Associated with Hypoxia-Inducible Factor-1α Increase, Are Involved in the Oxidative Stress of Graves' Orbital Adipocytes

xlomafota13 shared this article with you from Inoreader Downregulation of Caveolin-1 and Upregulation of Deiodinase 3, Associated with Hypoxia-Inducible Factor-1α Increase, Are Involved in the Oxidative Stress of Graves' Orbital Adipocytes Via liebertpub1 Thyroid, Volume 31, Issue 4, Page 627-637, April 2021. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Seltener Tumor im Oberlid

xlomafota13 shared this article with you from Inoreader Seltener Tumor im Oberlid Via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1475-5121 Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Therapie von Sprachentwicklungsstörungen: Eine Leitlinie ist längst überfällig

xlomafota13 shared this article with you from Inoreader Therapie von Sprachentwicklungsstörungen: Eine Leitlinie ist längst überfällig Via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1408-7599 Für die Therapie von Sprachentwicklungsstörungen (SES) ist bislang weitgehend unklar, wie die Evidenz aus individueller therapeutischer Expertise in das klinisch-praktische Vorgehen integriert wird. Die Entwicklung einer Leitlinie zur Therapie von SES, insbesondere für Kindergarten- und Vorschulkinder, ist daher aus 2 Gründen längst überfällig und zugleich eine besondere Herausforderung: (1) SES, die nicht im Zusammenhang mit einer Komorbidität stehen, werden mit verschiedenen Termini belegt und (2) bilden alle SES eine Schnittstelle medizinischer, psychologischer, pädagogischer, linguistischer und sprachtherapeutischer Fachdisziplinen. Die Deutsche Gesellschaft für Phoniatr ie und Pädaudiologie hat nun eine „Interdisziplinäre (S3-) Leitlinie zur Therapie von Sprachentwicklungsstörungen" (Register-Nr. 049–015) bei der Arbeitsgemeinschaft Wissenschaftlicher Medizinischer Fachgesellschaften AWMF e. V. angemeldet. Damit soll die Lücke zwischen sprachtherapeutischer Praxis und Forschungsevidenz geschlossen werden, um für den individuellen Behandlungsfall eine möglichst optimale Therapieempfehlung bzw. Therapieentscheidung treffen zu können – basierend auf dem besten wissenschaftlich verfügbaren Fachwissen. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of conte nts  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.