Wednesday, 19 September 2012
Continuous intracranial pressure monitoring in pseudotumour cerebri: Single centre experience
Published in: Br J Neurosurg. 2010 Oct;24(5):584-8.
Continuous intracranial pressure monitoring in pseudotumour cerebri: Single centre experience.
Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK. ahmedktoma@yahoo.com
Abstract
OBJECTIVE: Investigating pseudotumour cerebri (PTC) patients who do not fulfil the diagnostic criteria, or those presenting post-shunt insertion with recurrent symptoms and signs, with no clear evidence of shunt malfunction, present a diagnostic challenge. PTC patients who underwent continuous intracranial pressure (ICP) monitoring in our unit were reviewed retrospectively.
RESULTS: Twenty-six ICP monitoring procedures were done on 20 patients. Eleven patients had normal pressure, 2 overdrainage/low pressure, 11 underdrainage/high pressure and 2 variable pressures. On the basis of these results 12 patients were managed conservatively: 11 patients were referred to headache team and 1 patient had readjustment of an adjustable valve shunt setting; of those 3 patients had improved symptoms on their first post-operative clinic review. On the other hand, 14 patients had surgery: 5 had shunt revision and 9 had shunt insertion; of those 5 patients improved.
CONCLUSION: ICP monitoring using an intraparenchymal probe is a safe and effective diagnostic technique in investigating PTC when indicated. A multidisciplinary approach achieves best results in terms of successful management and follow-up
Abstract
OBJECTIVE: Investigating pseudotumour cerebri (PTC) patients who do not fulfil the diagnostic criteria, or those presenting post-shunt insertion with recurrent symptoms and signs, with no clear evidence of shunt malfunction, present a diagnostic challenge. PTC patients who underwent continuous intracranial pressure (ICP) monitoring in our unit were reviewed retrospectively.
RESULTS: Twenty-six ICP monitoring procedures were done on 20 patients. Eleven patients had normal pressure, 2 overdrainage/low pressure, 11 underdrainage/high pressure and 2 variable pressures. On the basis of these results 12 patients were managed conservatively: 11 patients were referred to headache team and 1 patient had readjustment of an adjustable valve shunt setting; of those 3 patients had improved symptoms on their first post-operative clinic review. On the other hand, 14 patients had surgery: 5 had shunt revision and 9 had shunt insertion; of those 5 patients improved.
CONCLUSION: ICP monitoring using an intraparenchymal probe is a safe and effective diagnostic technique in investigating PTC when indicated. A multidisciplinary approach achieves best results in terms of successful management and follow-up
An unusual aneurysm of a basilar perforating artery presenting with a subarachnoid haemorrhage.
Br J Neurosurg. 2012 Aug 30. [Epub ahead of print]
An unusual aneurysm of a basilar perforating artery presenting with a subarachnoid haemorrhage.
Source
Department of Neurosurgery, University Hospital of North Staffordshire, North Staffordshire Royal Infirmary , Stoke-on-Trent , UK.Abstract
A 65-year-old man had a perimesencephalic subarachnoid haemorrhage with normal angiography initially. After a rebleed 5 days later, a repeat angiogram revealed a pea-like aneurysm a short distance behind and below the basilar bifurcation. It was not amenable to endovascular treatment and the feeding vessel was coagulated and divided at open surgery via a sub temporal approach. He developed a right hemiparesis and dysphasia, from which he slowly recovered. Basilar perforating artery aneurysms are extremely rare, with only 4 previous cases reportedProposal for a British neurosurgical trainee research collaborative
Br J Neurosurg. 2012 Jun;26(3):434-5. Epub 2012 May 14.
.Proposal for a British neurosurgical trainee research collaborativeAbstract
High quality research in all surgical specialties is essential for improving patient care and outcome; neurosurgery is not an exception. Trainee collaborative networks have recently attracted considerable interest as they have a number of advantages for trainees and clinical research studies. We believe that neurosurgery represents a unique opportunity for the development of a similar nation-wide trainee research collaborative network. Our view is that this model will produce a sizeable cohort of registrars and consultants who will be actively engaged with collaborative multi-centre research studies, even though they will not necessarily be ‘academic’ neurosurgeons in the strict sense. In turn, this will help to ensure improved care and outcomes for our patients.
Read More: http://informahealthcare.com/doi/abs/10.3109/02688697.2012.690920
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