The bobble‐head doll syndrome

Benton, John W.; Nellhaus, Gerhard; Huttenlocher, Peter R.; Ojemann, Robert G.; Dodge, Philip R.

doi:10.1212/wnl.16.8.725

Cited by 88 publications

(54 citation statements)

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“…This was followed by seizures in 9 cases (14%), cerebellar symptoms in 5 cases (8%), ocular symptoms such as visual field deficits and optic nerve atrophy in 4 patients (6%), hemiparesis in 4 cases (6%), one case (2%) o f endocrinopathy associated with a supra sellar cyst, and 1 patient (2%) who presented with a breathing disorder secondary to a cerebellopontine angle cyst compressing the brain stem. Although symptoms and signs for patients in group 1 were not specifically tabu lated in our earlier report, 2 patients from group 1 with suprasellar cysts had evidence o f precocious puberty, while another was identified as having the 'bobble-head doll syndrome' [25],…”

Section: Presenting Symptoms and Signsmentioning

confidence: 63%

Surgical Treatment of 95 Children with 102 Intracranial Arachnoid Cysts

Fewel

Levy

McComb³

1996

Pediatr Neurosurg

117

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Our review of 95 children with 102 intracranial arachnoid cysts treated surgically from 1976 to 1996 is presented. These patients are divided into two groups, those initially treated from 1976 to 1986 and those treated from 1987 to May 1996, to see whether any improvement in outcome had occurred. There were 31 patients (20 males/11 females) with 34 cysts treated from 1976 to 1986 and 64 patients (45 males/19 females) with 68 cysts treated from 1987 to 1996. The mean age at presentation for all cases was 4.9 years (range from 3 days to 17.8 years). The most common cyst location was the middle fossa. Treatment options for the management of intracranial arachnoid cysts include fenestration or shunting. We consider the avoidance of a shunt as a primary goal in the management of these patients. Accordingly, 82 (80%) of the cysts in our series were treated initially by fenestration. Fifty percent of those initially fenestrated from 1976 to 1986 required no further treatment as compared with 60% fenestrated from 1987 to 1996. The success rate of fenestration among those patients without associated hydrocephalus was significantly higher than in those with hydrocephalus; 73% without hydrocephalus required no additional treatment versus 32% with hydrocephalus. Seventeen percent of the patients treated from 1976 to 1986 required a subsequent ven-triculoperitoneal shunt as compared with 22% treated from 1987 to 1996. Twenty-nine percent of those patients initially fenestrated from 1976 to 1986 required a subsequent cystoperitoneal shunt as compared with only 12% treated from 1987 to 1996. Although not statistically significant, the second group of patients had a lower rate of reoperation, fewer complications, and a better clinical outcome than the first group. We recommend that in patients without evidence of hydrocephalus, cyst fenestration be considered as the primary procedure, as 73% of the patients in the two series remain shunt free. In those patients with hydrocephalus, we still recommend cyst fenestration, but with a ventriculoperitoneal shunt inserted before fenestration if the hydrocephalus is marked or after fenestration if the hydrocephalus is progressive.

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Section: Presenting Symptoms and Signsmentioning

confidence: 63%

Surgical Treatment of 95 Children with 102 Intracranial Arachnoid Cysts

Fewel

Levy

McComb³

1996

Pediatr Neurosurg

117

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“…Bobble-head doll syndrome is, also, a rare but characteristic disorder described in children 33 34. It is characterised by episodic, involuntary head movements in flexion, extension or, less frequently, from side-to-side, which occur at a frequency of 2–3 Hz.…”

Section: Resultsmentioning

confidence: 99%

Intermittent head drops: the differential spectrum

Antelmi

Plazzi

Erro

et al. 2015

J Neurol Neurosurg Psychiatry

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Intermittent Head Drops are episodic head flexion movements that can occur in a number of conditions. Typically, the term has mainly been related to epileptic episodes, but the spectrum of clinical conditions associated with this feature is wide-ranging even if never discussed in detail. By searching the electronic database, we may find that apart from the epileptic conditions, Intermittent Head Drops have been in fact reported in the setting of movement disorders, sleep disorders and even internal medicine disorders, such as Sandifer syndrome. We render an in-depth description of this characteristic phenomenon in different diseases, describing the clinical clues and neurophysiological patterns that may help the clinician to distinguish between the different settings of occurrence.

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“…[9] and Williams and Guthkelch [29] described the temporal approach. When the re sults of the transcortical-transventricular and subfrontal approaches were compared, the latter appeared superior: all patients improved and only I (case I of Benton et ah [3]) required insertion of a VP shunt and case No. 4 of Segal et al [27] enjoyed regression of the precocious puberty 1 year after craniotomy.…”

Section: Discussionmentioning

confidence: 98%

“…The results were excellent inIn the reported cases, three types of treatment have been described: (I) shunting only [12,27,29]; (2) shunting followed by craniotomy [5,13], and (3) craniotomy without shunting [1,3,10,12,17,19,20,24,29] [5] opened the cyst wall between the optic nerves, creating wide communication between the cyst and the subarachnoid spaces. The patient of Kasdon et at.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical signs, pathological characteristics, and various theories on the etiology of approximately 40 suprasellar arachnoidal cysts have been dis cussed in the literature [1][2][3]21], Since the first reported by Barlow [2] in 1935, most authors have concerned themselves with the interesting aspects of the clinical picture ('bobble-head doll syndrome' [3,18], hypothalamopituitary syndrome [10,27]) and radiological findings.…”

Section: Introductionmentioning

confidence: 99%

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Suprasellar Cysts: Surgical Treatment and Results

Raimondi¹,

Shimoji²,

Gutiérrez³

1980

Pediatr Neurosurg

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The purpose of this paper is to present the clinical picture, diagnostic studies, and treatment of 5 cases of suprasellar cyst. The clinical symptoms and signs result from increased intracranial pressure without lateralizing signs (midline syndrome) and direct compression of the adjacent structures (hypothalmopituitary syndrome). The findings of computerized transmission tomography (CTT) and cerebral angiography in patients with suprasellar cyst are very similar to those of severe hydrocephalus. Cerebral angiography, however, reveals an inordinate mass effect in the parasellar area. Even though the location of the parasellar cyst is well demonstrated on postventriculoperitoneal shunt CTT scans, pneumonencephalography is necessary to confirm the diagnosis. We treated our patients with uni- or bilateral ventriculoperitoneal shunts, followed by craniotomy and cystosubarachnoid marsupialization. Cystoperitoneal shunting was performed after craniotomy in some instances, in place of it in others.

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The bobble‐head doll syndrome

Cited by 88 publications

References 0 publications

Surgical Treatment of 95 Children with 102 Intracranial Arachnoid Cysts

Surgical Treatment of 95 Children with 102 Intracranial Arachnoid Cysts

Intermittent head drops: the differential spectrum

Suprasellar Cysts: Surgical Treatment and Results

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