Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0264733 (ventricular dilatation)
 2,163 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to reconstruct the blocked CSF pathway, we attempted to excise the Liliequist membrane in 22 patients with subarachnoid hemorrhage resulted from ruptured intracranial aneurysms. After clipping the aneurysmal neck, the Liliequist membrane was reached through the space between the optic nerve and the internal carotid artery within the same operative field. As a result, the incidence of postoperative ventricular dilatation was remarkably reduced in comparison with control cases without Liliequist membranotomy. The necessity for the shunt operation for post-SAH hydrocephalus was also reduced. On the other hand, the incidence of postoperative subdural effusion increased in the group with Liliequist membranotomy. This suggests that the blockage of the arachnoid villi is probably the cause of disturbances in CSF absorption in some cases following subarachnoid hemorrhage. In such cases, the Liliequist membranotomy may be ineffective in restoring CSF circulation following subarachnoid hemorrhage.
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PMID:[Liliequist membranotomy for patients with ruptured intracranial aneurysms (author's transl)]. 52 68

Although recent advance in neurological surgery has diminished mortality rate of aneurysmal surgery, there still exist several complex problems for the management of aneurysms. Persistent neurological deficits or clinical deterioration after subarachnoid hemorrhage can result from subsequent communicating hydrocephalus which can be treated by shunting operation. We have studied alterations in the cerebrospinal fluid (CSF) circulation after SAH in 43 patients. Sources of hemorrhages were aneurysm in 30 cases, arteriovenous malformation in 6 and unknown in 7. Radioisotope cisternography was performed using 0.5 to 1.0 mCi of 169Yb-DTPA which was given intrathecally by lumbar injection. Results of cisternogram were classified into 4 groups and 7 subgroups; group 0: non filling (4%), group I: persistent ventricular filling (45%), A) absence of convexity flow (11%), B) partial convexity flow (34%), group II: transient ventricular filling (23%), A) delayed convexity flow (11%), B) normal convexity flow (12%), group III: no ventricular filling (28%), A) delayed convexity flow (17%), B) normal convexity flow (11%). The radioactivity in serial blood samples was measured by a well-type scintillation counter. Three types of curves for transfer of 169Yb-DTPA from CSF to blood were classified; delayed type, medium type, and normal type. In delayed type, the count ratio of blood activity at 24 hr to that at 3 hr is over 30%. In normal type, it is below 10%. There was a close correlation between cisternogram and transfer curve. In most cases with persistent ventricular filing, the transfer curve showed a delayed type. The relationship of cisternogram to classification of patient's condition by Hunt was studied. The grade of patient's condition was found to be closely related to the degree of abnormality in CSF circulation. The existence of rebleeding in the patients history was also found to influence the degree of abnormality in CSF circulation. However, single bleeding may also cause abnormality, such as persistent ventricular filling on cisternogram. In regard to the site of aneurysms, those of anterior communicating artery appeared to cause communicating hydrocephalus more frequently. Laterality of convexity flow was analyzed in 17 cases. All cases with internal carotid aneurysms showed decreased activity on the side of bleeding. Shunt operation was performed on 10 cases according to the results of cisternography, transfer curve, pneumoencephalography, and angiography. Seven cases showed improvement and 2 died of other complications soon after the shunt, and the effect of the procedure cannot be evaluated. Patients with clinical signs of NPH and abnormal cisternogram (group I) with evidence of ventricular dilatation are indicated for shunting operation.
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PMID:[Radioisotope cisternographic study on cerebrospinal fluid circulation after subarachnoid hemorrhage]. 123 20

350 patients with subarachnoid haemorrhage from aneurysmal rupture--admitted in the years 1966-1983--were selected for a retrospective controlled study on the efficacy of antifibrinolytic therapy (AFT). Patients treated with antifibrinolytics were divided into two groups, according to the day of hospital admission and onset of therapy, respectively between 0 and 3 days (SG 1) and between 4 and 7 days from SAH (SG 2); treated patients (260 cases) received i.v. tranexamic acid (6 gr/day) for at least two weeks. Patients admitted before 1974, not receiving antifibrinolytics (90 cases), were selected as controls and divided into two groups (CG 1 and CG 2), according to the day of admission. In the first study group (admission 0-3 days) the rebleeding rate within 2 weeks was 9% versus 23% in controls (p less than 0.01). The incidence of rebleeding within 3 and 4 weeks was also significantly lower (p less than 0.05) than in controls. No significant difference was observed in the rebleeding rate in treated and untreated patients with late admission (4-7 days). Mortality from rebleeding was 16% in the first study group versus 17% in controls; in the second study group the figure was 6% versus 8% in controls. Seventy-five cases of ischaemic disorders (29%) were registered in treated patients versus 13 cases in controls (14%; p less than 0.01). Thirty-seven patients receiving AFT (14%) developed significant ventricular dilatation requiring shunt insertion, versus one patient in the control groups (1%; p less than 0.001). Final outcome was similar in the 4 groups. In conclusion--according to our data--AFT modifies the behaviour of rebleeding and the patients' course, although it does not modify the outcome after SAH. Clinical use of antifibrinolytic therapy appears still justified in those patients who cannot be operated on in the acute stage after SAH, provided that an associated anti-ischaemic therapy is undertaken.
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PMID:Rebleeding, ischaemia and hydrocephalus following anti-fibrinolytic treatment for ruptured cerebral aneurysms: a retrospective clinical study. 317 35

In order to clarify the flow dynamics of cerebrospinal fluid (CSF) in normal pressure hydrocephalus (NPH), a phase-contrast cine magnetic resonance (MR) imaging technique with retrospective cardiac gating was used to measure the quantitative flow velocity of CSF in the aqueduct in patients with NPH after subarachnoid hemorrhage (SAH-NPH group, n = 17), idiopathic NPH (1-NPH group, n = 2), asymptomatic ventricular dilatation or brain atrophy (VD group, n = 7) and healthy volunteers (control group, n = 19). Intracranial pressure (ICP) and pressure volume response (PVR) were also measured during the shunt operation in six of the SAH- NPH group. The maximum CSF flow velocity (Vmax) in the aqueduct was significantly larger in the SAH-NPH group (9.21 +/- 4.12 cm/sec, mean +/- SD) than in the control group (5.27 +/- 1.77, p < 0.001) and the VD group (4.06 +/- 1.81, p < 0.005). Vmax was not different between the control and VD groups. There was a positive correlation between the PVR and the peak CSF flow velocity in the SAH-NPH group. These findings suggest that the changes of CSF flow velocity in the SAH-NPH group might be caused by a moderate decrease of intracranial compliance. The CSF flow study using MRI is useful to differentiate NPH from brain atrophy or asymptomatic ventricular dilatation and also to estimate the intracranial compliance.
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PMID:Quantitative analysis of CSF flow dynamics using MRI in normal pressure hydrocephalus. 977 27