Correlation of fetal ventricular size and need for postnatal cerebrospinal fluid diversion surgery in open spina bifida

2021 ◽  
Author(s):  
S. Agrawal ◽  
A. Al‐Refai ◽  
N. Abbasi ◽  
A. V. Kulkarni ◽  
V. Pruthi ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Spina Bifida ◽  
Ventricular Size ◽  
Cerebrospinal Fluid Diversion ◽  
Open Spina Bifida

scholarly journals OP03.09: Fetal ventricular size as a predictor of intervention for postnatal hydrocephalus in open spina bifida

2021 ◽  
Vol 58 (S1) ◽  
pp. 67-68
Author(s):  
S. Agrawal ◽  
A. Al‐Refai ◽  
N. Abbasi ◽  
A. Kulkarni ◽  
J. Drake ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Ventricular Size ◽  
Open Spina Bifida

Normal ventricular size in brain imaging does not exclude blockage of cerebrospinal fluid shunts

2006 ◽  
Vol 37 (03) ◽  
Author(s):  
S Parbel ◽  
S Vlaho ◽  
R Gerlach ◽  
L Porto ◽  
H Böhles ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Brain Imaging ◽  
Cerebrospinal Fluid Shunts ◽  
Ventricular Size

scholarly journals Neurosurgical experience of managing optic pathway gliomas

2021 ◽  
Author(s):  
Ciaran Scott Hill ◽  
Mehdi Khan ◽  
Kim Phipps ◽  
Katherine Green ◽  
Darren Hargrave ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Surgical Resection ◽  
Visual Function ◽  
Optic Pathway ◽  
Who Grade ◽  
Radiographic Findings ◽  
Surgical Interventions ◽  
Hypothalamic Dysfunction ◽  
Cerebrospinal Fluid Diversion ◽  
Optic Pathway Gliomas

Abstract Background Optic pathway gliomas (OPGs), also known as visual pathway gliomas, are debilitating tumors that account for 3–5% of all pediatric brain tumors. They are most commonly WHO grade 1 pilocytic astrocytomas and frequently occur in patients with neurofibromatosis type 1. The location of these tumors results in visual loss and blindness, endocrine and hypothalamic dysfunction, hydrocephalus, and premature death. Their involvement of the visual pathways and proximity to other eloquent brain structures typically precludes complete resection or optimal radiation dosing without incurring significant neurological injury. There are various surgical interventions that can be performed in relation to these lesions including biopsy, cerebrospinal fluid diversion, and partial or radical resection, but their role is a source of debate. This study catalogues our surgical experience and patient outcomes in order to support decision-making in this challenging pathology. Methods A retrospective review of all cases of OPGs treated in a single center from July 1990 to July 2020. Data was collected on patient demographics, radiographic findings, pathology, and management including surgical interventions. Outcome data included survival, visual function, endocrine, and hypothalamic dysfunction. Results One hundred twenty-one patients with OPG were identified, and 50 of these patients underwent a total of 104 surgical procedures. These included biopsy (31), subtotal or gross total resection (20 operations in 17 patients), cyst drainage (17), Ommaya reservoir insertion (9), or cerebrospinal fluid diversion (27). During the study period, there was 6% overall mortality, 18% hypothalamic dysfunction, 20% endocrine dysfunction, and 42% had some cognitive dysfunction. At diagnosis 75% of patients had good or moderate visual function in at least one eye, and overall, this improved to 83% at the end of the study period. In comparison the worst eye had good or moderate visual function in 56%, and this reduced to 53%. Baseline and final visual function were poorer in patients who had a surgical resection, but improvements in vision were still found—particularly in the best eye. Discussion/conclusion OPG are debilitating childhood tumor that have lifelong consequences in terms of visual function and endocrinopathies/hypothalamic dysfunction; this can result in substantial patient morbidity. Decisions regarding management and the role of surgery in this condition are challenging and include cerebrospinal fluid diversion, biopsy, and in highly select cases cystic decompression or surgical resection. In this paper, we review our own experience, outcomes, and surgical philosophy.

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