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ABSTRACT: Meningiomas are neoplasms that commonly involve the central nervous system of cats, while cholesteatomas are nodular granulomatous chronic lesions within the choroid plexus that are rarely reported in cats. This study described a case of cholesteatoma and non-communicating hydrocephalus associated to a third ventricle meningioma in a cat. Clinically, the cat had a 2-year history of behavioral changes, photophobia and motor incoordination. At the necropsy, a tan-brown mass totally occluded the third ventricle, causing a severe dilation of the lateral ventricles (non-communicating hydrocephalus). Microscopically, the mass was composed by a neoplastic proliferation of spindle cells arranged in bundles, containing in the center psammomatous bodies (meningioma), while in the adjacent areas a cholesteatoma was observed, which was characterized by multiple cholesterol cleft formation, hemosiderosis and associated granulomatous inflammation. At immunohistochemistry (IHC), neoplastic cells had a marked immunostaining for vimentin, while were negative for cytokeratin and S100. The diagnosis of transitional meningioma occurring in association to cholesteatoma and non-communicating hydrocephalus in a cat was obtained mainly by the histological and IHC features. These are important methods to distinguish this condition from other neurological disorders in cats.
RESUMO: Meningiomas são neoplasias que comumente envolvem o sistema nervoso central de gatos, enquanto colesteatomas são formações nodulares granulomatosas raramente descritas nessa espécie e que resultam de lesões crônicas em plexo coroide. O objetivo desse trabalho é descrever um caso de meningioma em terceiro ventrículo culminando com a formação de colesteatoma e hidrocefalia não comunicante em um gato. Clinicamente, o gato apresentava alteração de comportamento, fotofobia e incoordenação motora durante dois anos. À necropsia apresentava uma massa acastanhada no terceiro ventrículo que provocava oclusão total do mesmo e acentuada dilatação de ventrículos laterais (hidrocefalia não comunicante). Microscopicamente, havia proliferação neoplásica de células fusiformes arranjadas em feixes com a formação de corpos psamomatosos (meningioma), e em área adjacente havia múltiplas fendas de colesterol e hemossiderose com infiltrado granulomatoso (colesteatoma). À imuno-histoquímica (IHQ), foi observada marcação positiva para vimentina e negativa para citoqueratina e S100 nas células neoplásicas. Os exames histológicos e de IHQ contribuíram para a confirmação do diagnóstico de meningioma transicional associado à formação de colesteatoma e hidrocefalia não comunicante, e são métodos importantes para diferenciar de outras afecções que cursam com quadro clínico neurológico em felinos.
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Objective To investigate the effect of lumboperitoneal (L-P) shunt and ventriculoperitoneal(V-P) shunt for trea-ting the patients with communicating hydrocephalus .Methods The databases of PubMed ,Web of Science ,Scopuss ,Karge , EBSCO+MEDLINE ,OVID ,EMBASE ,CNKI ,CBM disc databases ,Wanfang databases ,Weipu databases were retrieved by com-puter .The relevant literatures about L-P shunt and V-P shunt for treating communicating hydrocephalus included in these databases during 1990-2016 were collected and performed the meta analysis by using the STATA 12 .0 software .Results The success rate of L-P shunt in treating communicating hydrocephalus was apparently higher than that of V-P shunt(P<0 .05) .Moreover ,postopera-tive infection rate ,obstruction rate of shunt system and total postoperative complications rate in L-P shunt were apparently lower than those of V-P shunt(P<0 .05) ,However ,there was no statistical difference in shunt poor rate between L-P shunt and V-P shunt(P>0 .05) .Conclusion L-P shunt is worth recommending .But due to lower quality of the evidences ,it is needed more high quality primary studies to remedy the insufficiency of the study .
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Objective To explore the advantages and application of adjustable shunt valve in treatment of chil-dren with Communicating hydrocephalus. Methods Eighty six consecutive children undergoing surgery treatment for Communicating hydrocephalus from January 2006 to July 2011 were included in this retrospective study. Fifty cases re-ceived adjustable shunt valve whereas the rest received standard shunt valve. Results The success rate was 84.00% in the adjustable shunt valve group and 63.89%in the standard shunt valve group. Complication rate was 16.00%in the ad-justable shunt valve group and 36.11% in the standard shunt valve group. Inadequate and excessive shunt rate was 69.23% in the standard shunt valve group and zero% in adjustable shunt valve group. Compared with standard shunt valve group, adjustable shunt valve group had significantly higher success rate and lower complication rate (All P<0.05). Conclusions Adjustable shunt valve effectively reduce the complication rate and improve the success rate. In addition, adjustable shunt valve is superior to standard shunt valve in the treatment of children with communicating hydrocephalus because it fits for the development of children.
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Objective To assess the clinical effect of lumboperitoneal shunting (LPS) on communicating hydrocephalus.Methods An retrospectively study was conducted on communicating hydrocephalus patients who were hospitalized from Sep.2009 and Dec.2013 at the No.174th Hospital of Chinese People's Liberation Army.All patients were underwent the LPS.All patients were with difference degrees of coma,and lumbar punctured for continued cerebrospinal fluid extended drainage before LPS.The change of disturbance of consciousness and the complications of LPS were assessed.Results There were 12 patients with communicating hydrocephalus.Of them,7 cases were underwent routine lumboperitoneal shunts,and 5 cases were experienced adjustment valve.After the LPS operation,3 patients were awakened from the coma,and 8 patients were improved in terms of consciousness and the decompression pressure of skull window as well as decreased enlarged lateral ventricles in pre-operation by CT.As for another 1 patient,the lumboperitoneal catheter had been slipped into the peritoneal cavity after 2 months of operation.There were no complications of infection,intracranial hemorrhages,obstruction of catheter and epilepsy.Conclusion The LPS should be the first selection of those patients who suffered from communicating hydrocephalus without trouble in spine and abdomen.A positive response to pre-operative continuing cerebrospinal fluid extend drainage is good prediction factor for surgical results of LPS.
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Objective To summarize the experience of the ventriculoperitoneal shunt (VPS) in communicating hydrocephalus and its complications. Methods The clinical features, operative techniques and outcome of 100 patients with hydrocephalus were analysed retrospectively. Results Ninety-five (95%) cases had a good result. Postoperative complications were found in 6(6%) cases including shunt apparatus blockage (4 cases) and shunt infection (2 cases). All the cases improved after taking the corresponding measures. Conclusion VPS is the most common shunt style for communicating hydrocephalus. The shunt apparatus blockage and infection are common postoperative complications. Intraoperative aseptic technique, the minimally invasive procedure, and the optimal placement of shunt tube may play an important role in improving the outcome of cerebrospinal fluid shunting surgery for communicating hydrocephalus.
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Spontaneous migration of the shunt catheter into the posterior cranial fossa is very rare complication of lumboperitoneal shunt operation. The authors report a case with communicating hydrocephalus following ruptured intracranial aneurysm for which a lumboperitoneal shunt was placed. Four years later, she was presented with low back pain after the slip-down in jury, and radiologic studies revealed compression fracture at T12 and intracranial migration of shunt catether into the posterior fossa. From our knowledge, there is only one other such case reported in the literature.
Subject(s)
Catheters , Cranial Fossa, Posterior , Fractures, Compression , Hydrocephalus , Intracranial Aneurysm , Low Back PainABSTRACT
OBJECTIVE: A 10-year retrospective lumboperitoneal(LP) shunt surgery was reviewed in order to verify the several prognostic factors including the etiology, the findings of brain computed tomography(CT) and/or magnetic resonance imaging(MRI), and the effect of lumbar drainage which have been implicated in the result of LP shunt. PATIENTS AND MEHTODS: A series of 32 patients who underwent LP shunt surgery between March 1988 and May 1998 for the management of communicating hydrocephalus was reviewed. RESULTS: The etiology of communicating hydrocephalus was subarachnoid hemorrhage(SAH) in 19 cases(59.4%), head trauma in 10 cases(31.2%), intracerebral hemorrhage in 2 cases(6.3%), meningitis in 1 case(3.1%), tumor in 1 case(3.1%), and idiopathic in 2 cases(6.3%). The mean follow-up period was 1.2 years(range, 2 week to 8.5 year). Among them, twenty four patients(75%) were clinically improved after shunt operation. The result of LP shunt was not related to the etiologies and many findings of brain CT/MRI such as ventricular index, Evan's index, periventricular low density, obliteration of cerebral sulci and cortical atrophy. However, the result of LP shunt was significantly related to the effect of preoperative lumbar drainage(p=0.0184). CONCLUSION: This result suggests that the effect of preoperative lumbar drainage has a significant role in predicting the result of LP shunt in patients with communicating hydrocephalus.
Subject(s)
Humans , Atrophy , Brain , Cerebral Hemorrhage , Craniocerebral Trauma , Drainage , Follow-Up Studies , Hydrocephalus , Meningitis , Retrospective StudiesABSTRACT
The author reviewed a series of 48patients who underwent lumbo-peritoneal shunt operation at Taegu Catholic University Hospital during recent five years. Among them, 10 cases were excluded in this study because of their poor neurologic status which was not adequate to estimate the operative result. In our series, lumbo-peritoneal shunt was done in 34 cases of communicating hydrocephalus due to aneurysmal subarachnoid hemorrhage, head injury, spontaneous intracerebral hemorrhage with/without intraventicular hemorrhage and brain tumor, 2 cases of pseudomeningocele and 2 cases of normal pressure hydrocephalus. The results of this review demonstrate clinical improvement in 28 cases(73.7%), 10 cases(26.7%) of no clinical improvement. There were 9 complications including 8 shunt dysfunction and 1 infection. Among the 8 cases of shunt dysfunction, 5 cases showed postoperative early clinical improvement but revealed shunt dysfunction of delayed onset. In conclusion, lumbo-peritoneal shunt was considered as a good initial CSF diversion procedure in the treatment of communicating hydrocephalus and pseudomeningocele.
Subject(s)
Brain Neoplasms , Cerebral Hemorrhage , Craniocerebral Trauma , Hemorrhage , Hydrocephalus , Hydrocephalus, Normal Pressure , Subarachnoid HemorrhageABSTRACT
The effect of lumboperitoneal(LP) shunt and the prognostic factors of 40 cases of communicating hydrocephalus confirmed by brain computerized tomography(CT) and/or magnetic resonance imaging(MRI) and radioisotope cisternography(RI) were analyzed. Possible prognostic factors such as disease entity, CT or MRI findings, and the type of radioisotope cisternography were compared to improvement of clinical status after LP shunt. The etiology of communicating hydrocephalus in the analyzed 40 cases included trauma in 13 cases(32.5%), subarachnoid hemorrhage(SAH) in 12 cases(30%), intracerebral hemorrhage(ICH) in 10 cases(25%), and idiopathic in 5 cases(12.5%). An overall clinical improvement after LP shunt was seen in 22 cases(55%). However, in 17 cases of SAH and idiopathic group, improvement after LP shunt was seen in 13 cases(75%), indicating that LP shunt is more effective in SAH/idiopathic group than trauma/ICH group(p<0.05). Many findings of brain CT/MRI such as Evan's index, periventricular low density, 3rd ventricular width, obliteration of cerebral sulci, rounding of frontal horn, and cortical atrophy were analyzed as prognostic factors. Except for the absence of cortical atrophy(p<0.05), none of the factors were related to the patient's outcome. The type of abnormal RI cisternography findings(Typ I, II, III) also did not show any relationship with the effectiveness of LP shunt. These findings suggest that SAH/idiopathic group were more favorable candidates for LP shunt than trauma/ICH group, and that there are no reliable brain CT/MRI findings indicating a good prognosis after LP shunt except for the absence of cortical atrophy. RI cisternography findings are also not a reliable diagnostic tool in evaluating the indication of LP shunt in communicating hydrocephalus.
Subject(s)
Animals , Atrophy , Brain , Horns , Hydrocephalus , Magnetic Resonance Imaging , PrognosisABSTRACT
A series of 70 lumboperitoneal shunt performed at Yonsei university Severance hospital was reviewed. The clinical indications for this procdures were communicating hydrocephalus, CSF fistulas, benign intracranial hypertension and bulging craniectomy site. There were several complications such as shunt migration, obstruction, infection and nonfunctioning. Wound dehiscence, epidural hematoma and ingumal hernia were also observed after shunting. This procedure is completely extracranial and diminished intracranial complications, thereby significantly reducing morbidity and mortality. Good results were reported due to easy insertion, short operation time and reduced complications. This report documented the efficacy of lumbopertoneal shunt and literatures were reviewed.
Subject(s)
Fistula , Hematoma , Hernia , Hydrocephalus , Mortality , Pseudotumor Cerebri , Wounds and InjuriesABSTRACT
Authors experienced the lumboperitoneal shunt in 13 patients. There were 8 communicating hydrocephaluses, 2 benign intracranial hypertensions, 2 cerebrospinal fluid fistulas and 1 postcraniectomy bulging. Lumboperitoneal shunt was thought to be a very simple extracranial procedure which reduce the complications from ventriculoperitoneal shunt such as subdural fluid collection, subdural hematoma, slit ventricle syndrome and conversion from communicating hydrocephalus to non-communicating hydrocephalus. The efficacy of this procedure was documented and literatures were reviewed.