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  • 1
    Electronic Resource
    Electronic Resource
    Pericerebral collections after shunting (1987)
    Springer
    Child's nervous system 3 (1987), S. 97-102 
    Details
    ISSN: 1433-0350
    Keywords: Subdural hematoma ; Epidural hematoma ; Shunt complications ; Hydrocephalus ; CSF overdrainage ; Siphon effect
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Nineteen pericerebral collections (18 subdural and 1 epidural) occurred in a series of 682 consecutive initial shunt insertions for hydrocephalus in children, performed between 1976 and 1984. No collections were observed in 358 reoperations performed in the same patients during the same period. The incidence rate of this complication is nearly four times higher after 2 years of age than in younger children (6.5% versus 1.7%). The rate is also higher, regardless of age, in noncommunicating than in communicating hydrocephalus. Pericerebral collections are observed with high- as well as low-closing pressure valves. Pericerebral collections after shunting were diagnosed in 80% of the cases less than 2 months after surgery. They were asymptomatic in nearly 60% of the cases but could become symptomatic later when they were not treated. At the onset at least, these pericerebral collections are compensated by the outflow of an equal quantity of intraventricular CSF so that ICP is only moderately elevated. Postshunt pericerebral collections may be the consequence of CSF loss at the time of surgery. In most cases, however, they are due to a CSF overdrainage by the valve. This overdrainage, together with the reversal of CSF flow in the highly resistant CSF pathways of hydrocephalus, establishes a pressure lower in the ventricles than in the subarachnoid space and tends to open up the subdural space. The treatment of postshunt subdural collections is the insertion of a simple tubing without valve between the subdural space and the peritoneum, the ventriculoperitoneal shunt being left in place. With this treatment, more than 80% of the collections disappeared or were improved. No complications or secondary aggravation were observed in any of these patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00271133
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  • 2
    Electronic Resource
    Electronic Resource
    Surgery of hydrocephalus: past, present and future (1992)
    Springer
    Acta neurochirurgica 116 (1992), S. 155-160 
    Details
    ISSN: 0942-0940
    Keywords: Hydrocephalus ; ventriculo-cisternostomy ; shunt complications ; CSF overdrainage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The treatment of hydrocephalus, over the centuries, underwent three stages of evolution. During antiquity, middle ages and Renaissance, hydrocephalus was not understood. Medical treatment was useless; surgery was hopeless. The second stage extends from the XIXth century to the end of the first half of the XXth century. CSF circulation was now understood; surgery however, remained inefficient, but some patients survived with arrested hydrocephalus. The third stage begins in the nineteen fifties with the development of silicone shunts with a valve. Surgery transforms the prognosis of hydrocephalus, but the number of post-operative complications creates new problems. The different attempts that have been made during these past two decades to solve these problems are reviewed. They have resulted in a reduction of the mechanical and infectious complications. CSF overdrainage has been minimized. Percutaneous ventriculocisternostomies have in some cases replaced shunts. In the future, to improve outcome in these hydrocephalics, surgery, when indicated, should be performed as early as possible. Knowledge and prevention of the causes of hydrocephalus should be developed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01540869
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  • 3
    Electronic Resource
    Electronic Resource
    Acute intracranial hematomas in term neonates (1986)
    Springer
    Child's nervous system 2 (1986), S. 191-194 
    Details
    ISSN: 1433-0350
    Keywords: Neonatology ; Intracranial hematomas ; Hydrocephalus ; Dystocic deliveries ; Perinatal anoxia ; Bleeding disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Acute intracranial hematomas in 17 term neonates are reported: 3 were subdural in the posterior fossa; 14 supratentorial, either subdural (8), intracerebral (1 frontal, 4 occipital) or intraventricular (1). The hematomas were aspirated in 3 cases and surgically evacuated in 10. In the remaining 4, the effusion was left in situ. Three patients died: 2 due to dramatic preoperative deterioration and 1 to hemostatic difficulties during surgery. In the 14 survivors, neurological sequellae are major in 3, nil or minor in 11. Comparison of these cases to the 110 others already published allows the following conclusions: (1) the cause of such hematomas is usually multifactorial, combining obstetrical trauma, anoxia and/or coagulation disorders; (2) early diagnosis of the hematoma requires early echography and/or tomodensitometry; (3) when the hematoma causes a midline shift, the authors advocate its early evacuation by aspiration, or craniotomy if it is clotted; (4) the prognosis is poor when there is associated severe perinatal anoxia; if there is no anoxia, the prognosis seems good, but as the follow-up is usually short, definite conclusions are difficult; (5) in our series hydrocephalus requiring treatment occurred in 2 of the 14 survivors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00706809
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  • 4
    Electronic Resource
    Electronic Resource
    Consensus: long-term outcome in hydrocephalus (1994)
    Springer
    Child's nervous system 10 (1994), S. 64-69 
    Details
    ISSN: 1433-0350
    Keywords: Hydrocephalus ; Etiology ; Treatment ; History ; Outcome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Developments in the treatment of hydrocephalus and its outcome are traced from the time of Hippocrates up to the present day. various factors that have been suspected of influencing the outcome are discussed and their relative importance for long-term outcome is reviewed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00313587
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    Paper (German National Licenses)
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