MR Elastography demonstrates reduced white matter shear stiffness in early-onset hydrocephalus

Wagshul, Mark E.; McAllister, James P.; Limbrick, David D.; Yang, Sheng; Mowrey, Wenzhu; Goodrich, James Tait; Meiri, Avital; Morales, Diego M.; Kobets, Andrew J.; Abbott, Rick

doi:10.1016/j.nicl.2021.102579

Cited by 15 publications

(2 citation statements)

References 132 publications

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“…[9][10][11] The high prevalence of subdural effusions in infants is likely because of the fact that their brain parenchyma has less stiffness and yields more easily after a decrease of IVP resulting in rupture of the bridging veins in the subarachnoid space. 32,33 We could not document age as a risk factor, however, whereas human infants often undergo surgery in their first days of life, dogs and cats are usually not operated on during their neonatal phase. The subgroup most at risk in humans is therefore not included in our study group.…”

Section: Discussionmentioning

confidence: 96%

Risk factors, treatment, and outcome in dogs and cats with subdural hematoma and hemispheric collapse after ventriculoperitoneal shunting of congenital internal hydrocephalus

Farke,

Siwicka,

Olszewska

et al. 2023

Veterinary Internal Medicne

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BackgroundOvershunting and hemispheric collapse are well‐known complications after ventriculoperitoneal shunt (VPS) implantation. Risk factors that predispose to overshunting, treatment options, and prognosis after therapeutic intervention have not been described.Hypothesis/ObjectivesTo identify preoperative risk factors for overshunting, the effect of surgical decompression, and their outcomes.AnimalsSeventy‐five dogs and 7 cats.MethodsRetrospective case cohort study. Age, breed, sex, body weight, number of dilated ventricles, ventricle brain ratio, intraventricular pressure, and implanted pressure valve systems were evaluated as possible risk factors.ResultsOvershunting had a prevalence of 18% (Cl 95% 9.9‐26.66). An increase of 0.05 in VBR increased the risk of overshunting by OR 2.23 (Cl 95% 1.4‐3.5; P = .001). Biventricular hydrocephalus had the highest risk for overshunting compared to a tri‐ (OR 2.48 with Cl 95% 0.5‐11.1) or tetraventricular hydrocephalus (OR 11.6 with Cl 95% 1.7‐81.1; P = .05). There was no influence regarding the use of gravitational vs differential pressure valves (P > .78). Overshunting resulted in hemispheric collapse, subdural hemorrhage, and peracute deterioration of neurological status in 15 animals. Subdural hematoma was removed in 8 dogs and 2 cats with prompt postoperative improvement of clinical signs.Conclusions and Clinical ImportanceBiventricular hydrocephalus and increased VBR indicate a higher risk for overshunting. The use of differential valves with gravitational units has no influence on occurrence of overshunting related complications and outcomes. Decompressive surgery provides a favorable treatment option for hemispheric collapse and has a good outcome.

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Section: Discussionmentioning

confidence: 96%

Risk factors, treatment, and outcome in dogs and cats with subdural hematoma and hemispheric collapse after ventriculoperitoneal shunting of congenital internal hydrocephalus

Farke,

Siwicka,

Olszewska

et al. 2023

Veterinary Internal Medicne

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“…Recent advances in imaging modalities such as MR elastography may provide some important insights into the pathophysiological changes taking place in acute and chronic hydrocephalus and therefore how to best treat these conditions. 41,42 Lowpressure hydrocephalus appears to be a risk factor for the development of HT. Management of low-pressure hydrocephalus remains complex, but current principles include negative CSF drainage to reduce ventriculomegaly, followed by interventions such as neck wrapping aimed at increasing venous pressures and brain stiffness, and placement of a VPS with an adjustable or low-pressure valve.…”

Section: Discussionmentioning

confidence: 99%

Treatment-responsive Holmes tremor in a child with low-pressure hydrocephalus: video case report and systematic review of the literature

Chang

Mitchell

Hukin

et al. 2022

Journal of Neurosurgery: Pediatrics

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OBJECTIVE Holmes tremor (HT) is a rare and debilitating movement disorder comprising both rest and action tremor, and it is known for its resistance to treatment. Its most common causes include ischemic or hemorrhagic insults and trauma. Mechanistically, the combined rest and action tremor is thought to require a double lesion of both the dopaminergic nigrostriatal system and the dentatorubrothalamic pathways, often near the midbrain where both pathways converge. The aim of this study was to characterize HT as a presenting sign in cases of hydrocephalus and to discuss potential pathomechanisms, clinical presentations, and treatment options. METHODS MEDLINE and Web of Science were searched for cases of HT with hydrocephalus from database inception to August 2021, and these were compiled along with the authors’ own unique case of treatment-responsive HT in a child with low-pressure obstructive hydrocephalus secondary to a tectal tumor. Patient characteristics, presenting signs/symptoms, potential precipitating factors, interventions, and patient outcomes were recorded. RESULTS Nine patients were identified including the authors’ video case report. All patients had a triventriculomegaly pattern with at least a component of obstructive hydrocephalus, and 4 patients were identified as having low-pressure hydrocephalus. Parinaud’s syndrome and bradykinesia were the most commonly associated signs. Levodopa and CSF diversion were the most commonly used and effective treatments for HT in this population. This review was not registered and did not receive any funding. CONCLUSIONS HT is a poorly understood and probably underrecognized presentation of hydrocephalus that is difficult to treat, limiting the strength of the evidence in this review. Treatment options include CSF diversion, antiparkinsonian agents, antiepileptic agents, deep brain stimulation, and MR-guided focused ultrasound, and aim toward the nigrostriatal and dentatorubrothalamic pathways hypothesized to be involved in its pathophysiology.

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Mechanical properties of pediatric low-grade gliomas in children with and without neurofibromatosis type 1

McIlvain,

Hayes,

Walter

et al. 2024

Neuroradiology

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Introduction Prognoses for pediatric brain tumors are suboptimal, as even in low-grade tumors, management techniques can lead to damage in the developing brain. Therefore, advanced neuroimaging methods are critical for developing optimal management plans and improving patient care. Magnetic resonance elastography (MRE) has allowed for the characterization of adult gliomas by their mechanical properties, which are uniquely sensitive to the complex interplay of cellularity, vasculature, and interstitium. However, pediatric tumors differ in behavior and cytoarchitecture, and their mechanical properties have never been assessed. Methods Here, we conduct the first study of pediatric brain tumor mechanical properties by using MRE to measure tissue stiffness and damping ratio in low grade gliomas (LGGs). We additionally measure the mechanical properties of non-neoplastic focal abnormal signal intensities (FASIs) in children with neurofibromatosis type 1 (NF1). Results 23 patients age 4–17 years who had MR imaging results consistent with a primary LGG or with NF1 were included in this study. We found that pediatric gliomas are on an average 10.9% softer (p = 0.010) with a 17.3% lower (p = 0.009) viscosity than reference tissue. Softness of tumors appeared consistent across tumor subtypes and unrelated to tumor size or contrast-enhancement. In NF1 we found that, unlike gliomas, FASIs are stiffer, though not significantly, than reference tissue by an average of 10.4% and have a 16.7% lower damping ratio. Conclusions Measuring tumor mechanical properties patterning and heterogeneity has potential to aid in prediction of biological behavior and inform management strategies for pediatric patients.

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MR Elastography demonstrates reduced white matter shear stiffness in early-onset hydrocephalus

Cited by 15 publications

References 132 publications

Risk factors, treatment, and outcome in dogs and cats with subdural hematoma and hemispheric collapse after ventriculoperitoneal shunting of congenital internal hydrocephalus

Risk factors, treatment, and outcome in dogs and cats with subdural hematoma and hemispheric collapse after ventriculoperitoneal shunting of congenital internal hydrocephalus

Treatment-responsive Holmes tremor in a child with low-pressure hydrocephalus: video case report and systematic review of the literature

Mechanical properties of pediatric low-grade gliomas in children with and without neurofibromatosis type 1

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