OBJECTIVE A new ventriculostomy technique through the lamina terminalis is described. This technique is applied mainly during aneurysm surgery at the acute stage. METHOD Thirteen patients were operated on intracranial aneurysms and, during the procedure, had the lamina terminalis fenestrated. A ventricular catheter was inserted into the third ventricule, left in place and connected to an exte...

AIM Traditional craniotomies for treatment of the aneurysms at the A3 segment of anterior cerebral artery (A3As), such as frontal approach and interhemispheric approach, require pre-hairline incision and relatively long incision, extensive bone flap, inevitable supraorbital nerve injury, opening frontal sinus, and increased operative time. Here we reported anterior interhemispheric keyhole appr...

OBJECTIVES Initial evidence suggests that total cavopulmonary connection (TCPC) completion during winter is associated with prolonged pleural effusion and hospitalization. This study was carried out to review the impact of season of operation on short-term outcome after TCPC procedure. METHODS We conducted a retrospective study on 104 consecutive patients who underwent the extracardiac TCPC p...

OBJECTIVES The aim of the study was to investigate if pleurocentesis in patients with pleural effusion would lead to changes in systolic and diastolic function of the left ventricle. DESIGN The study was descriptive, and patients were their own controls. SETTING The setting was a single-center university hospital. PARTICIPANTS Patients with pleural effusion requiring pleurocentesis were e...

BACKGROUND AND PURPOSE Both intraventricular fibrinolysis (IVF) and lumbar drainage (LD) may reduce the need for exchange of external ventricular drainage (EVD) and shunt surgery in patients with intracerebral hemorrhage and severe intraventricular hemorrhage. We investigated the feasibility and safety of IVF followed by early LD for the treatment of posthemorrhagic hydrocephalus. METHODS Thi...

To cite: Kobayashi H, Suzuki T, Tokuda Y. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2013201148 DESCRIPTION A 78-year-old woman with the history of spinal stenosis presented to our emergency room by ambulance with the acute onset of back pain and mild altered mental status. On examination, there was knock pain over the right costovertebral angle. Urinalysis s...

Evidence-based guidelines for the management of hemorrhagic and ischemic cerebellar stroke are sparse, and most available data come from Class III studies. As a result, opinions and practices regarding the nature and role of neurosurgical intervention vary widely. A comprehensive literature review was conducted to adjudicate several contentious issues, such as the difference in the management o...

Cerebral salt wasting (CSW) is a rare complication in posterior fossa tumour surgery. We present two patients with cerebellopontine angle (CPA) tumours who developed cerebral salt wasting postoperatively. Both patients deteriorated in spite of intensive fluid and salt replacement. On CT scan the patients presented mild to moderate ventricular dilation, which was treated with an external ventric...

Cerebrospinal fluid (CSF) leak or shunt overdrainage is a well-known cause of orthostatic headaches and low CSF pressures. We report two cases of orthostatic headache with pneumocephalus on brain imaging. The orthostatic headache developed after drainage of spinal operation site and epidural block. Brain MRI revealed characteristic findings of CSF hypovolemia including pachymeningeal enhancemen...

We present a patient with hydrocephalus after tuberculous meningitis successfully treated with urokinase. She presented with multiple episodes of headache, fever, and vomiting. She underwent external ventricular drainage and was treated with urokinase in addition to dexamethasone, acetazolamide, and 4 antituberculous drugs. She was evaluated clinically, radiologically, and by laboratory work-up...