External ventricular drain - Wikipedia
An external ventricular drain (EVD), also known as a ventriculostomy or extraventricular drain, is a device used in neurosurgery to treat hydrocephalus and relieve elevated intracranial pressure when the normal flow of cerebrospinal fluid (CSF) inside the brain is obstructed. An EVD is a flexible plastic catheter placed by a neurosurgeon or neurointensivist and managed by intensive care unit (ICU) physicians and nurses. The purpose of external ventricular drainage is to divert fluid from the ventricles of the brain and allow for monitoring of intracranial pressure. An EVD must be placed in a center with full neurosurgical capabilities, because immediate neurosurgical intervention can be needed if a complication of EVD placement, such as bleeding, is encountered. EVDs are a short-term solution to hydrocephalus, and if the underlying hydrocephalus does not eventually resolve, it may be necessary to convert the EVD to a cerebral shunt, which is a fully internalized, long-term ...https://en.wikipedia.org/wiki/External_ventricular_drain
"Paediatric external ventricular drains: experience from a tertiary car" by Abbas Qalab, Rayaan Asad et al.
Abstract The aim of the study was to describe indications and complications of external ventricular drain (EVD) placement in children aged between 1 month and 16 years. This retrospective chart review was conducted at the Aga Khan University Hospital, Karachi, and comprised all children who underwent EVD placement from January 2007 to December 2014. Of the 177 patients identified, 117(66%) were males 60(34%) were girls. The overall mean age was 5.4±5.2 years. The median Glasgow Coma Scale score on presentation and discharge was 13 (interquartile range [IQR]: 7) and 15 (IQR: 4), respectively. Major diagnosis included intracranial tumour 60(34%), bacterial meningitis 34(19%), tuberculous meningitis 33(18.6%), and haemorrhage 23(13%). Clinical indications for EVD insertion were acute hydrocephalus secondary to infection 64(36.2%), tumour 54(30.5%), and haemorrhage 23(13%) ventriculoperitoneal shunt malfunction or infection 25(14.1%) and traumatic brain injury 11(6.2%). Complications were observed in 47(26https://ecommons.aku.edu/pakistan_fhs_mc_surg_surg/108/
Cerebrospinal Fluid Pharmacokinetics of Daptomycin. - AdisInsight
This trial will invwsigate the pharmacokinetics of daptomycin in patients with external ventricular drain related meningitis or ventriculitis.http://adisinsight.springer.com/trials/700051590
History of the Management of Meningitis and Ventriculitis in Children
Vaccinations: Immunization and improvements in public health hold the keys to decreasing the incidence and consequences of these infections. With the introduction of H. influenzae type b conjugate vaccines in 1990, there has been a dramatic decline in H. influenzae type b meningitis in developed countries. Similarly, the introduction of pneumococcal vaccines in 2000 resulted in a dramatic decrease in pneumococcal meningitis. Although there are vaccines against several serotypes of meningococcus, there is as yet no effective vaccine against the most common, serotype B ...https://www.ispn.guide/infections-of-the-nervous-system-in-children/meningitis-and-ventriculitis-in-children-homepage/history-of-the-management-of-meningitis-and-ventriculitis-in-children/
Recommended Reading for Meningitis and Ventriculitis in Children
deJonge RCJ, van Furth AM, Wassenaar M, et al: Predicting sequelae and death after bacterial meningitis in childhood: A systematic review of prognostic studies. BMC Infect Dis 20:232, ...https://www.ispn.guide/infections-of-the-nervous-system-in-children/meningitis-and-ventriculitis-in-children-homepage/recommended-reading-for-meningitis-and-ventriculitis-in-children/
Follow-up for Meningitis and Ventriculitis in Children
Neuropsychological testing: These tests may be beneficial in assessing cognitive effects in patients recovering from severe infections. Even in more indolent infections, subtle neurocognitive changes may be followed once the post-illness baseline is established. In school-age children, school performance provides a measure of progress as well ...https://www.ispn.guide/infections-of-the-nervous-system-in-children/meningitis-and-ventriculitis-in-children-homepage/management-of-meningitis-and-ventriculitis-in-children/follow-up-for-meningitis-and-ventriculitis-in-children/
The impact of ventricular catheter impregnated with antimicrobial agents on infections in patients with ventricular catheter:...
INTRODUCTION Previous prospective study in our unit had shown that the use of dual antibiotic prophylaxis in patients with external ventricular drain was associated with decreased incidence of cerebrospinal fluid infection but complicated with opportunistic extracranial infection. In recent years, cerebrospinal fluid shunt catheters impregnated with antimicrobial agents have become available. Theoretically, these catheters provide antibiotic prophylaxis locally without the associated complications of systemic opportunistic infection. METHODS We carried out a prospective randomized, controlled clinical trial in a regional neurosurgical center in Hong Kong. We recruited patients admitted for emergency neurosurgical operation after informed consent was obtained from next-of-kin. Eligible patients were randomized to receive an antibiotic-impregnated ventricular catheter or plain ventricular catheter Dual prophylactic antibiotic coverage was given to the patients randomized for ...https://www.semanticscholar.org/paper/The-impact-of-ventricular-catheter-impregnated-wit-Wong-Poon/217843e0c157efad7cb0c4584c7a9a0ac46c7a42
Carly Grace: July 2009
Since this journey began in September 2008, I have known that Carly was both a little miracle and a tough fighter. Never has she had to show that more than on this trip. The medical staff at UCSF are amazing, but Carly still managed to keep everyone guessing for so many weeks. The complete story will never be known for sure, but the version we are sticking with is this: Carly had a virus or some other type of stomach issue that caused severe abdominal pain. As the pain worsened, her body was not able to mount an appropriate adrenal response because she does not have her pituitary glad. She went into adrenal shock, despite the stress dose of hydrocortisone that we injected into her leg, and we had to rush her to the emergency room. After she was stabilized they did scans of her head and even used an external ventricular drain to make sure she didn't have excessive intracranial pressure. At that time her cranial pressure was fine so the search moved on from her head. During the next few weeks she ...http://carlygracenelson.blogspot.com/2009_07_01_archive.html
Meet Leonard - Medulloblastoma - The Gold Hope Project
In October 2015, Leonard started having headaches. They were constant and persistent. Soon after, he began randomly vomiting every two to three days. By November, he began to lose his balance and couldn't walk straight. A trip to the emergency room (and a CT scan) confirmed what we suspected: Leonard had a brain tumor.. He was admitted to Children's Hospital of Wisconsin and had an external ventricular drain placed to relieve pressure in his brain. A few days later he underwent a craniotomy to remove the tumor. We received pathology the following week from St. Jude-the tumor was medulloblastoma. Cancer. And our 5 year old would have to endure radiation treatment, chemotherapy, and all the things that come with them. He struggled to eat throughout treatment, and he felt awful for so long that being sick became "normal." When his nurse would ask him how he felt, he would reply that he felt fine, even if he was holding a vomit bucket as he walked down the hall. It had just become status quo. It was ...http://goldhopeproject.com/meet-leonard-medulloblastoma/
Teresa L. Jacobs | MCubed
Jeffrey J. Fletcher; William Meurer; Malcolm Dunne; Venkatakrishna Rajajee; Teresa L. Jacobs; Kyle M. Sheehan; Bart Nathan; Allison M. Kade. Inter-observer agreement on the diagnosis of neurocardiogenic injury following aneurysmal subarachnoid hemorrhage. Neurocritical Care. 2014;20(2):263-269.. Yana Mikhaylov; Thomas J. Wilson; Venkatakrishna Rajajee; B. Gregory Thompson; Cormac O. Maher; Stephen E. Sullivan; Teresa L. Jacobs; Mary J. Kocan; Aditya S. Pandey. Efficacy of antibiotic-impregnated external ventricular drains in reducing ventriculostomy-associated infections. Journal of Clinical Neuroscience. 2014;21(5):765-768.. Venkatakrishna Rajajee; Jeffrey J. Fletcher; Lauryn R. Rochlen; Teresa L. Jacobs. Comparison of accuracy of optic nerve ultrasound for the detection of intracranial hypertension in the setting of acutely fluctuating vs stable intracranial pressure: Post-hoc analysis of data from a prospective, blinded single center study. Critical Care. 2012;16(3):[R79].. ...http://mcubed.umich.edu/users/teresmit
Neuroradiology On the Net: febbraio 2010
Brain sonograms obtained in the first 2-3 days can be normal but days later show asymmetrical white matter hyperechogenicity due to widespread destruction. This is later followed by development of multiple cysts, often with rims of hyperechogenicity around them. Multiple areas of parenchymal or intraventricular hemorrhage may also be demonstrated on ultrasound. Sometimes, brain sonography shows intraventricular septa and thickened ependyma due to ventriculitis. CT features include diffuse hypodensity of the white matter with multiple areas of hemorrhage and abscesses. The abscesses may undergo cavitatory necrosis and calcification. On MRI, multiple, confluent white matter hyperintensities are seen on T1W images and hypointensities on T2W images, both consistent with hemorrhagic destruction. DWI show restricted diffusion in the brain parenchyma due to cytotoxic edema and may also show lesions that were not detected on conventional MR images. The rate at which the findings develop sequentially ...http://neuroradiologyonthenet.blogspot.com/2010_02_01_archive.html
GMS | 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC) 1. Joint Meeting mit der Ungarischen...
Treatment options for geriatric patients with intracerebral hemorrhages are limited. In many cases, no surgical treatment is applied because of the poor prognosis of this patient group. Also, often only minimally invasive procedures such as placement of an external ventricular catheter are favored. However, other procedures such as an endoscopic 3rd ventriculostomy could reduce the risk of ventriculitis and long-term dependence on implant material. Here we present our series of patients of more than 70 yrs of age who received an endoscopic 3rd ventriculostomy for the treatment of acute hydrocephalus caused by cerebellar or intraventricular hemorrhage.. ...http://www.egms.de/static/de/meetings/dgnc2004/04dgnc0032.shtml
According to the recall notice, the devices were recalled because the patient line tubing can be separated from the patient line connectors; this is more likely occur during frequent handling and include connections were injections or sampling occur often. The notice stated that "The device failure may result in air within the skull (pneumocephalus), infection (such as meningitis, ventriculitis, encephalitis) and over/under drainage of the CSF that may contribute to serious adverse health consequences, including death.". The recalled systems were manufactured between March 15, 2013 and February 28, 2014. They were distributed between April 10, 2013 and May 19, 2014. An Urgent Device Recall letter was sent out to customers last month.. A Medtronic spokesperson told Mass Device that the company received 35 reports of adverse events between September 2013 and April 2014. No deaths have been reported thus far.. A Class I label means that exposure to the recalled device could lead to serious ...http://www.newsinferno.com/49544/
The Dogghouse: No Place Like Home
Matt and I spent yet another night in the ICU of St.Josephs hospital last night. We started at the internal medicine doctor yesterday but when they checked his temperature it was 101.7. The doctor sent us straight back to the hospital suspecting that we were dealing with an infection in Matts shunt or possibly menengitis. We were very worried and tired. They took large needle and a pressure gauge and tapped into his shunt to retrieve some cerebral spinal fluid. They sent it off to be cultured. There was protein in it which indicates infection. The resident consulted infectious diseases and together they decided that they needed to watch him for ventriculitis (an infection in the ventricles in the brain). They admitted him to the ICU and it was all too familiar. They watched his fever closely overnight and waited for more results. Finally this morning when his fever had broken they discharged him and said that they would continue to culture the fluid. If it comes back with ...http://aubreygarff.blogspot.com/2010/09/no-place-like-home.html
Aerosolized and Intravenous Colistin in Healthy Adults - Full Text View - ClinicalTrials.gov
Inclusion Criteria:. 1. Informed consent obtained and signed 2. Aged between 18 and 45 years, inclusive 3. Body Mass Index (BMI, weight in kg divided by the square of height in meters) between 18 and 35.0 kg/m^2, inclusive 4. Able to comply with protocol requirements for the entire duration of the study 5. Healthy on the basis of a screening medical evaluation (including physical examination, vital signs, blood biochemistry and hematology, urinalysis, and history).. Exclusion Criteria:. 1. Heterosexually active females of child-bearing potential, defined as being physiologically capable of becoming pregnant, unless they agree to use two of the following acceptable methods of contraception throughout their participation in the study and for at least 12 weeks after the final dose: (a) established use of oral, injected or implanted hormonal contraception, (b) intrauterine Device (IUD or Coil) (c) a female barrier method (diaphragm or cervical/vault cap) and/or (d) condom plus spermicidal cream/gel ...https://clinicaltrials.gov/ct2/show/NCT01863719?recr=Open&cond=%22Pneumococcal+Infections%22&rank=8
Aerosolized and Intravenous Colistin in Healthy Adults - Full Text View - ClinicalTrials.gov
Inclusion Criteria:. 1. Informed consent obtained and signed 2. Aged between 18 and 45 years, inclusive 3. Body Mass Index (BMI, weight in kg divided by the square of height in meters) between 18 and 35.0 kg/m^2, inclusive 4. Able to comply with protocol requirements for the entire duration of the study 5. Healthy on the basis of a screening medical evaluation (including physical examination, vital signs, blood biochemistry and hematology, urinalysis, and history).. Exclusion Criteria:. 1. Heterosexually active females of child-bearing potential, defined as being physiologically capable of becoming pregnant, unless they agree to use two of the following acceptable methods of contraception throughout their participation in the study and for at least 12 weeks after the final dose: (a) established use of oral, injected or implanted hormonal contraception, (b) intrauterine Device (IUD or Coil) (c) a female barrier method (diaphragm or cervical/vault cap) and/or (d) condom plus spermicidal cream/gel ...https://clinicaltrials.gov/ct2/show/NCT01863719?term=NIAID&recr=Open&no_unk=Y&cond=healthy&rank=18
Epidermoid tumor of the interhemispheric fissure | SpringerLink
Altschuler EM, CA Jungreis, LN Sekhar, PJ Janetta, PE Sheptak: Operative treatment of cranial epidermoid cysts and cholesterol granulomas: Report of 21 cases. Neurosurgery 26 (4) (1990) 606-614PubMedGoogle Scholar ...https://link.springer.com/article/10.1007%2FBF01390529
Monro Wright & Wasbrough
At Monro Wright & Wasbrough LLP we provide high quality and cost-effective advice, combining old-fashioned values with a contemporary approachhttp://www.mww-llp.com
THE CLINICAL CASES OF MEDICINE ROTATION CONTEST VIDEO PRESENTATION STARTS AT THE UNIVERSITY MIGUEL HERNÁNDEZ WITH NEW AWARDS -...
The Department of Clinical Medicine of UMH has decided to convene the 'Jaime Merino Contest video presentation of clinical cases of Medicine UMH rotation'.http://www.departamentomedicinaclinicaumh.es/12136/
Familial Intracranial Aneurysm Study II - Full Text View - ClinicalTrials.gov
Intracranial aneurysms are 'blisters' which form within the arteries at the base of the brain. A rupture of an aneurysm may lead to subarachnoid hemorrhage (SAH). The mortality rates of patients suffering from a SAH is 40 to 44 percent , with many survivors enduring major disability. Most of the deaths from SAH are due to rapid and massive brain injury from the initial bleeding, which is not correctable by medical and surgical intervention. Thus, prevention of aneurysm formation is of paramount importance.. Scientific evidence suggests that a genetic component plays an important role in the development of intracranial aneurysms, however the specific genes have not been identified. The Familial Intracranial Aneurysm Study is a collaborative research effort of neurologists and neurosurgeons throughout the United States, Canada, Australia and New Zealand to identify possible genes that may increase the risk of stroke, and particularly, the development of ...https://clinicaltrials.gov/ct2/show/study/NCT00071565
Risk-benefit analysis of the treatment of unruptured intracranial aneurysms
Objectives: To determine under what circumstances repair of unruptured intracranial aneurysms may be beneficial. Methods: A life expectancy analysis of patients with unruptured aneurysms with and without repair based on prospective data from the International Study of Unruptured Intracranial Aneurysms (ISUIA). Results: Life years are lost at all ages by repairing anterior circulation aneurysms under 7 mm in diameter in patients with no history of a subarachnoid haemorrhage from another aneurysm (incidental). For all other aneurysms the number of life years saved by repair is dependent on the patient's age at the time when repair is undertaken. Between 2 and 40 years are saved by repairing aneurysms in patients aged 20 years. These benefits fall to 0 when remaining life expectancy falls below 15-35 years, corresponding to the age range of 45-70 years. Conclusions: Repair of unruptured ...http://connection.ebscohost.com/c/articles/16896901/risk-benefit-analysis-treatment-unruptured-intracranial-aneurysms
Abstract 14: Size Ratio can be a Strong Predictor for Future Rupture of the Unruptured Cerebral Aneurysms | Stroke
Introduction: Various factors have been nominated for the rupture of unruptured cerebral aneurysms including size, shape and specific locations of aneurysms. Size ratio, which is the quotient of maximum size of the aneurysm divided by the diameter of the adjacent parent artery, has also been nominated as a strong indicator to discriminate ruptured versus unruptured cerebral aneurysms. However, this has never been tested as a risk in the prospective cohort. In this paper, we have assimilated size ratio in cases of UCAS Japan using reported average parent arterial size and evaluated its value.. Methods: We used average main intracranial artery diameter reported in anatomical studies as follows: AComA: 1.5mm, MCA: 3.9mm, ICA: 4.3mm, PComA: 1.3mm, BA: 4.1mm and VA: 3.9mm. UCAS Japan cohort, which is a Japanese prospective cohort of unruptured cerebral aneurysms in Japan, were utilized (6,312 ...http://stroke.ahajournals.org/content/47/Suppl_1/A14
Intracranial aneurysm - Wikipedia
Intracranial aneurysm, also known as brain aneurysm, is a cerebrovascular disorder in which weakness in the wall of a cerebral artery or vein causes a localized dilation or ballooning of the blood vessel. Aneurysms in the posterior circulation (basilar artery, vertebral arteries and posterior communicating artery) have a higher risk of rupture. Basilar artery aneurysms represent only 3%-5% of all intracranial aneurysms but are the most common aneurysms in the posterior circulation. Cerebral aneurysms are classified both by size and shape. Small aneurysms have a diameter of less than 15 mm. Larger aneurysms include those classified as large (15 to 25 mm), giant (25 to 50 mm), and super-giant (over 50 mm). Saccular aneurysms, also known as berry aneurysms, appear as a round outpouching and are the most common ...https://en.wikipedia.org/wiki/Intracranial_aneurysm
North Shore University Hospital's Brain Aneurysm Center Offers New Pipeline® Embolization Device to Treat Complex Brain...
The PED is a flexible, braided wire mesh tube which can be placed within the internal carotid artery in the brain, blocking off large or wide-necked aneurysms. The device can also reduce the likelihood that an aneurysm will rupture. "The Pipeline® Embolization Device offers neurointerventional surgeons a minimally invasive alternative to open surgery or placement of materials such as coils or a liquid embolic when treating carotid artery brain aneurysms," said Avi Setton, MD, chief of interventional neuroradiology at North Shore University Hospital. "While coiling can be effective for small brain aneurysms, it does not always work on larger ones. The PED device offers patients a better chance of long-lasting aneurysm occlusion and low complication rates.". In the endovascular procedure, the PED is threaded up through a catheter placed in a blood vessel in the leg, up to the brain. The PED is implanted across the neck of the aneurysm, cutting off blood flow. ...https://www.healthcanal.com/brain-nerves/22985-north-shore-university-hospitals-brain-aneurysm-center-offers-new-pipeline-embolization-device-to-treat-complex-brain-aneurysms.html
Flow Diverter Stent for Endovascular Treatment of Unruptured Saccular Wide-necked Intracranial Aneurysms - Full Text View -...
Unruptured saccular intracranial aneurysms larger than 7 mm can be treated with endovascular occlusion using detachable coils, with or without expendable stent assistance. A new endovascular technique has recently been developed, using flow diverter stents without associated coils. Clinical results already published are encouraging but have to be confirmed. Furthermore, these medical devices are expensive in comparison to the coiling strategy. The purpose of this study is to compare the clinical efficacy, safety, and cost-effectiveness of endovascular coiling and endovascular flow diversion for unrupted saccular intracranial aneurysms ...https://clinicaltrials.gov/ct2/show/NCT01811134?recr=Open&cond=%22Intracranial+Aneurysm%22&rank=5