ABSTRACT
Objective To explore the effects of ventriculoperitoneal shunt(VPS) placement in those children with grade Ⅳ tuberculous meningitis with hydrocephalus (TBMH) clinical analysis.Methods Nine cases of grade Ⅳ TBMH who received VPS from Jan.2006 to Dec.2009 were retrospectively reviewed,including age,gender,disease development,clinical manifestations,laboratory data,treatment,prognosis and complications.All children received VPS placement combined with pharmacal treatment.External ventricular drainage(EVD) were given only 2 cases with severe biochemical derangements or brainstem dysfunction requiring correction before shunt surgery.Outcomes were divided into normal,mild sequelae,severe sequelae,death or vegetable status.Results The average follow-up period was 15 months.Two patients had a full recovery,3 patients had slight sequelae,2 patients had severe sequela,and another 2 patients expired.Four cases complications related to the shunt surgery were seen,1 patient had shunt block,2 patients had infections and 1 patient had subdural effusion and ventricular hemorrhage.Conclusions Directly VPS surgery can improve the outcome of grade Ⅳ TBMH.The response of EVD is not a reliable indication for selecting patients who would benefit from shunt surgery.
ABSTRACT
<p><b>OBJECTIVE</b>To study the role of neuroglobin (Ngb) in the pathologic process of contusion and laceration of brain in children.</p><p><b>METHODS</b>The proteins in the brain tissue were extracted by two-dimensional gel electrophoresis in 3 children undergoing brain ventricular neoplasms resection (normal brain tissue) and in 8 children with contusion and laceration of brain. The image analysis was done using the PDQuest 7.0 software. The differential protein spots were detected and analyzed with Applied Biosystems Voyager System 4307 MALDI-TOF Mass Spectrometer and bioinformatical skills. Ngb expression in the brain tissue was measured using immunohistochemisty. Ngb expression in plasma was measured using ELISA in 15 children with contusion and laceration of brain and 10 healthy children.</p><p><b>RESULTS</b>Expression maps of the brain tissue were established by two-dimensional gel electrophoresis in children with contusion and laceration of brain and healthy children. Six differential protein spots were found and 5 of them were identified by mass spectrum. Immunohistochemisty assay showed that Ngb expression in the brain tissue in children with contusion and laceration of brain was significantly higher than in normal controls (P<0.05). ELISA results showed that Ngb expression in the plasma increased significantly 6, 12, 18, 24 and 48 hours after trauma in children with contusion and laceration of brain compared with healthy children (P<0.01).</p><p><b>CONCLUSIONS</b>Ngb may play an important role in the pathologic process of contusion and laceration of brain in children.</p>
Subject(s)
Adolescent , Child , Female , Humans , Male , Brain Injuries , Metabolism , Electrophoresis, Gel, Two-Dimensional , Enzyme-Linked Immunosorbent Assay , Globins , Immunohistochemistry , Nerve Tissue Proteins , Spectrometry, Mass, Matrix-Assisted Laser Desorption-IonizationABSTRACT
<p><b>OBJECTIVE</b>Multilocular brain abscess in children is a serious neurosurgical emergency and remains a serious, life-threatening disease. This study evaluated the role of neuroendoscopy in treating multilocular brain abscess in children.</p><p><b>METHODS</b>Between January 2002 and June 2007, 16 children with multilocular brain abscess underwent an operation using a pure endoscopic procedure.</p><p><b>RESULTS</b>Increased intracranial pressure was relieved after operation in the 16 patients. CT/MRI after operation showed the abscess cavities disappeared and only the residual abscess walls existed in the 16 patients. Fourteen patients were followed up for 6 months to 5 years after surgery. Abscess walls disappeared in 13 patients and abscess recurred only in 1 patient.</p><p><b>CONCLUSIONS</b>Neuroendoscopy for treatment of multilocular brain abscess is safe and effective in children.</p>