Priorities for hydrocephalus research: report from a National Institutes of Health–sponsored workshop

Williams, Michael A.; McAllister, James P.; Walker, Marion L.; Kranz, Dory; Bergsneider, Marvin; Bigio, Marc R. Del; Fleming, Laurel; Frim, David M.; Gwinn‐Hardy, Katrina; Kestle, John R. W.; Luciano, Mark; Madsen, Joseph R.; Oster-Granite, Mary Lou; Spinella, Giovanna

doi:10.3171/ped-07/11/345

Cited by 63 publications

(70 citation statements)

References 160 publications

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“…Surgical management is also of considerable interest and substantial variation [14,16,17,22], with shunt removal or new shunt placement ranging from 55% to 71% and externalization ranging from 12% to 37% [14,15,17]. The superiority of any surgical approach in preventing CSF shunt reinfection is unclear [14,15,17,23]. Although we found no differences between those with and without reinfection in surgical approach, we also observed far less variation in surgical approaches than the 3 earlier studies, with 90% of the cohort undergoing shunt removal or new shunt placement.…”

Section: Discussionmentioning

confidence: 99%

“…Medical management of CSF shunt infection, and specifically IV antibiotic use in CSF shunt infection treatment, is an area of considerable interest and variation [14,16,17,22,23]. Although IV antibiotics are a mainstay of clinical practice in conjunction with surgery [13,24,25], duration of IV antibiotic use varies widely [14] and depends, in part, on the surgical approach used [1,26] and pathogen involved [25,27].…”

Section: Discussionmentioning

confidence: 99%

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Few Patient, Treatment, and Diagnostic or Microbiological Factors, Except Complications and Intermittent Negative Cerebrospinal Fluid (CSF) Cultures During First CSF Shunt Infection, Are Associated With Reinfection

Simon¹,

Mayer-Hamblett²,

Whitlock³

et al. 2013

Journal of the Pediatric Infectious Diseases Society

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Background. The relationship between first and subsequent cerebrospinal fluid (CSF) shunt infections is poorly understood. By understanding the factors associated with increased risk of reinfection, researchers may provide optimal treatment strategies at the time of first infection. The objective of this study was to describe and compare children with and without CSF shunt reinfection. Methods. A retrospective cohort study was performed among 118 children who underwent initial CSF shunt placement and developed first CSF shunt infection. The primary outcome variable was CSF shunt reinfection. Patient risk factors and medical and surgical management of initial CSF shunt placement and first CSF shunt infection were compared between children with and without reinfection. Results. Of 118 children with first infection, 31 (26%) developed a reinfection during the study period (overall median follow-up, 2096 days). Factors associated with reinfection in this cohort included ventriculoatrial or complex shunt at initial CSF shunt placement, complications after first CSF shunt infection, and intermittent negative CSF cultures. Conclusions. Few patient or treatment factors were associated with reinfection. Factors associated with difficult-to-treat first CSF shunt infection, including complications after first CSF shunt infection and intermittent negative CSF cultures, were associated with reinfection. Clinicians who treat patients with unusual CSF shunts or more difficult first infections should have a high index of suspicion for reinfection after treatment is completed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Few Patient, Treatment, and Diagnostic or Microbiological Factors, Except Complications and Intermittent Negative Cerebrospinal Fluid (CSF) Cultures During First CSF Shunt Infection, Are Associated With Reinfection

Simon¹,

Mayer-Hamblett²,

Whitlock³

et al. 2013

Journal of the Pediatric Infectious Diseases Society

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“…Compression and distortion of brain tissue give rise to deleterious effects, such as inflammatory responses, gliosis, fiber stretching, damage to neurons and cellular pathways, destruction of periventricular axons, demyelination, reduced cerebral blood flow and oxygen levels, and altered clearance of proteins and toxins [8][9][10]22,25,33], that may be associated with neurological deficits in hydrocephalus patients, including low intelligent quotient (IQ) scores, learning disabilities, memory loss, mental retardation, impaired gait, and urinary incontinence [12,13]. These deleterious effects of hydrocephalus on the brain depend on the magnitude and duration of ventriculomegaly and degree of compression of brain tissue, which are also modified by the age of onset [9].…”

Section: Introductionmentioning

confidence: 99%

Hydrocephalus induced via intraventricular kaolin injection in adult rats

Zhang¹,

Wang²,

Xu³

et al. 2015

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A b s t r a c t Hydrocephalus is a common neurological disease in humans, but a uniform and particularly effective hydrocephalic animal model amenable to proper appraisal and deep study has not yet been established. In this study, we attempted to construct a high-efficiency model of hydrocephalus via intraventricular kaolin injection. Adult male SpragueDawley rats were randomly divided into 2 groups: the control group (n = 15) and the experimental group (n = 30). Kaolin was injected into the lateral ventricle of experimental animals. Control rats underwent the same procedure but received sterile saline injection instead of kaolin. All animals with kaolin injection into the lateral ventricle developed hydrocephalus according to magnetic resonance imaging (MRI) results (success rate up to 100%

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“…Williams et al (2007), definiram-na como um aumento do volume dos ventrículos cerebrais secundário à alteração da secreção, circulação ou reabsorção liquórica, resultando no aumento da pressão intracraniana (PIC) e surgimento de sintomas / sinais clínicos.…”

Section: Lista De Figurasunclassified

“…Mais comumente reconhecida como uma condição típica da faixa etária pediátrica, a hidrocefalia também ocorre em adolescentes, adultos e idosos (WILLIAMS et al, 2007).…”

Section: Lista De Figurasunclassified

Análise dos efeitos clínico-radiológicos, histopatológicos e bioquímicos da derivação ventrículo-subcutânea na hidrocefalia induzida por caulim em ratos

Santos¹

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AGRADECIMENTOS"Ofereço, a todos que contribuíram para este trabalho, aquele âmago de mim que consegui salvar, de alguma maneira -o coração central que não lida com palavras, não trafica com sonhos e que é intocado pelo tempo, pela alegria, por adversidades." À minha esposa Leila, pelo apoio e amor incondicionais, e meus filhos Maria e Rafael, sem os quais a vida não teria sentido.A todos os meus familiares, especialmente meus pais Celso e Marlei, meus irmãos Patrícia e Fábio, meus sogros Lourival (in memoriam) e Gecilda e meus cunhados, que proporcionaram todas as condições para meu desenvolvimento pessoal e profissional.Ao Prof. Dr. Ricardo Santos de Oliveira, mestre e amigo, com quem aprendo continuamente e cujo exemplo seguirei orgulhosamente. As palavras não são suficientes para agradecê-lo. Introdução.A hidrocefalia é uma doença de complexa fisiopatologia, que não só afeta a dinâmica do líquido cefalorraquidiano (LCR), mas também outras estruturas do sistema nervoso central, e consequentemente pode trazer sequelas graves em crianças. Sua fisiopatologia, principalmente no nível bioquímico-celular, ainda é pouco conhecida. Objetivos. Avaliar aspectos clínicos (ganho ponderal, comportamento motor e memória), radiológicos (razão ventricular e transferência de magnetização), histopatológicos (astrocitose reativa e proliferação celular na matriz germinativa) e bioquímicos (presença de interleucinas inflamatórias no líquor) na fase aguda da hidrocefalia experimental induzida por caulim e o efeito do tratamento com derivação adaptada (ventrículo-subcutânea). Materiais e métodos.Utilizaram-se ratos Wistar com 7 dias de vida, que foram divididos em três grupos: controle sem injeção de caulim (n = 5), hidrocefálico sem tratamento (n=17), e hidrocefálico tratado com derivação ventrículo-subcutâneo (DVSC), a partir do 7 o dia pós-indução (n=24 Introduction. Hydrocephalus is a complex disease, which affects not only cerebrospinal fluid dynamics, but also other cerebral structures, and therefore may result in severe disability for children. Its pathophysiology is still widely unknown, especially on a cellular-biochemical level. Objectives. Assessment of clinical (weight gain, behavior), radiological (ventricular index and magnetization transfer ratio), histopathological (reactive astrocytosis and cell proliferation over the germinal matrix) and biochemical (dosage of inflammatory interleukins) aspects of acute kaolin-induced experimental hydrocephalus and the effects of the treatment with an adapted shunt (ventricular-subcutaneous). Methods. 7-day-old Wistar rats were divided into three groups: untreated hydrocephalic (n=17), hydrocephalic treated with shunt on the 7 th day after induction (n=24) and controls (n=5). Hydrocephalic animals, both treated and untreated, were injected with a 15% kaolin solution on the cisterna magna, to produce hydrocephalus. Results. Weight gain was similar on both hydrocephalic groups but lower than in controls. Motor behavior was also worse than controls for both groups, but treated animal...

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Priorities for hydrocephalus research: report from a National Institutes of Health–sponsored workshop

Abstract: The research priorities of this workshop provide critical guidance for future research in hydrocephalus, which should result in advances in knowledge, and ultimately in the treatment for this important disorder and improved outcomes in patients of all ages.

Cited by 63 publications

References 160 publications

Few Patient, Treatment, and Diagnostic or Microbiological Factors, Except Complications and Intermittent Negative Cerebrospinal Fluid (CSF) Cultures During First CSF Shunt Infection, Are Associated With Reinfection

Few Patient, Treatment, and Diagnostic or Microbiological Factors, Except Complications and Intermittent Negative Cerebrospinal Fluid (CSF) Cultures During First CSF Shunt Infection, Are Associated With Reinfection

Hydrocephalus induced via intraventricular kaolin injection in adult rats

Análise dos efeitos clínico-radiológicos, histopatológicos e bioquímicos da derivação ventrículo-subcutânea na hidrocefalia induzida por caulim em ratos

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