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Disorders of Circulation of the Cerebrospinal Fluid
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Usual causes of communicating hydrocephalus include: Infection (meningitis, ventriculitis).Inflammation (neurosarcoidosis, lupus cerebritis).Hemorrhage (intraventricular hemorrhage, subarachnoid hemorrhage).
Meningitis
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Bacteria can reach the subarachnoid space via haematogenous spread, contiguous spread as a complication of otitis media, sinusitis or orbital cellulitis through bone erosion or thrombophlebitis. A third mechanism is via septic emboli in the case of endocarditis. Severe complications of meningitis are ventriculitis and brain abscess.
Corpus Callosotomy
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
The surgical technique for callosotomy as elaborated by Wilson et al. was modified following an unacceptable number of perioperative complications including one death in the first series of eight patients (12). Avoiding entry into the ventricular system was adopted and may be the reason for a decreased report of ventriculitis and hydrocephalus (12,47,52). One-stage total callosotomy was replaced by a two-stage operation starting with either the posterior half or anterior one half to three quarters of the callosum (12,29,47). Most centers have now adopted anterior callosotomy as the first step (29,36,47). Completion of callosotomy is carried out if generalized seizure control is inadequate after an observation period of 4 or more months. Some centers have restricted surgery to anterior callosotomy alone (17,23,27), or a partial callosotomy related to intraoperative electrical studies (37). A recent review (53) of the results of anterior one half to three quarters callosotomy alone versus two-stage completion section revealed that the complete procedure has been successful in markedly decreasing or eliminating generalized seizures (generalized tonic-clonic, tonic, atonic and absence spells) in 80 to 90% of patients, whereas partial section has been similarly effective in 50% or less. Recent reviews by Roberts (47,52) elaborate the technical aspects of callosotomy.
Global epidemiology and changing clinical presentations of invasive meningococcal disease: a narrative review
Published in Infectious Diseases, 2022
Ala-Eddine Deghmane, Samy Taha, Muhamed-Kheir Taha
Meningococcal meningitis is usually limited to the localisation of bacteria in this sub-arachnoidal space with usually no complicated forms in other compartments such as the cerebral parenchyma or the dura mater [45]. However, high proinflammatory isolates (such as the emerging isolates of serogroup W/CC11) in addition to host factors may provoke unusual complications of meningitis [46]. Pachymeningitis is a neurological complication that corresponds to an inflammatory response of the dura mater associated with perivasculitis [47]. This pathology is therefore driven by an exacerbated inflammatory response that can be linked to promoter variants in three genes involved in the inflammatory response (IL-6, plasminogen activator inhibitor-1, PAI-1 and macrophage migration inhibitory factor, MIF) suggesting that this form may benefit from corticosteroid adjuvant therapy [47]. Meningitis can also be complicated by ventriculitis. Magnetic resonance imaging (MRI) is required to confirm the diagnosis (periventricular hyperintensities and moderate dilatation of the lateral ventricles) [48]. It is therefore recommended when the evolution of meningococcal meningitis is poor under optimal treatment to explore such complications using imaging and exploring inflammatory response.
Intraventricular administration of tigecycline for the treatment of multidrug-resistant bacterial meningitis after craniotomy: a case report
Published in Journal of Chemotherapy, 2018
Yuanxing Wu, Kai Chen, Jingwei Zhao, Qiang Wang, Jianxin Zhou
In the present case, the approximate three-month duration of meningitis might relate processing ventriculitis; the computed tomography (CT) data is presented in Figure 1. The CT shows oedema adjacent to the ventricles. Images from prior ventriculoscopy also verified the deposition of cellulose in the ventricles, which are presented in Figure 2. The trough concentrations of tigecycline in CSF for the three different dosages of IV–ICV tigecycline were 0.313, 1.290 and 2.886 mg/L for 40 mg IV/10 mg ICV, 45 mg IV/5 mg IC and 50 mg IV/1 mg ICV tigecycline, respectively. The highest dose of ICV tigecycline demonstrated the optimal trough concentration, which was higher than the knownMIC90 for tigecycline against K. pneumoniae of 2 mg/L.16
Endoscopic neuroendoscopy using a novel ventricular access port
Published in British Journal of Neurosurgery, 2018
Andrew John Gauden, Calum Pears, Andrew Parker, Kelvin Woon, Helge Köck, Martin Hunn, Warren Symons, Agadha Wickremesekera
Of the 86 patients 28 patients (32.5%) had a diagnosis of cerebral aqueductal stenosis. Of the remaining causes, hydrocephalus secondary to a neoplastic lesion was the most common cause in 30 patients (34.8%). Of these patients 9 patients (10.4%) had histological confirmation of a high-grade glioma and 4 patients had evidence of cerebral metastatic lesions (4.6%). 10 patients (11.6%) had a subsequent diagnosis of normal pressure hydrocephalus and four patients (4.7%) had evidence of prior shunt blockage. Three patients (3.5%) had evidence of hydrocephalus secondary to ventriculitis/meningitis and two patients (2.3%) had evidence of intraventricular haemorrhage. The remaining 9 patients (10.5%) had hydrocephalus of unknown aetiology.