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Third ventriculostomy is the preferred treatment for obstructive hydrocephalus, but the biomechanics of brain tissue damage caused by fiber endoscopes remains unclear. In this study, brain tissue material parameters were tested based on the Ogden model to simulate needle puncture mechanics, and replicated the entire fiber endoscope advancement process during third ventriculostomy. It was found that a smaller diameter fiber endoscope, a perpendicular puncture angle, and a faster puncture speed would decrease the damage of brain tissue caused by the fiber endoscope. This study provides valuable insights for optimizing the instrumentation and surgical process of third ventriculostomy. [ABSTRACT FROM AUTHOR]

We present the application of the Raumedic® P-tel telemetric device that monitors Intracranial Pressure (ICP) over long periods, in 22 patients, with suspected intracranial hypertension. A telemetric device (Raumedic®, Neurovent® P-tel) was surgically implanted in 22 patients aged between 21 and 65 years. Among the patients, the inconclusive diagnosis of benign intracranial hypertension was set in 10, the possible diagnosis of postoperative hydrocephalus in 3, and the possible diagnosis of aqueduct stenosis in 2. Additionally, shunt malfunction and Normal Pressure Hydrocephalus (NPH) were investigated in 1 and 3 patients, respectively. Finally, 3 patients presented ventricular dilatation of unknown origin. All the individuals underwent a 3-day ICP recording within the nursing unit. Three more recordings were obtained over a period of 2–6 months at the outpatient base. Analysis of the data excluded the diagnosis of intracranial hypertension in 12 patients. Elevated ICP values were confirmed in 10 patients. Subsequently, 7 of them underwent shunts' implantation, while 2 refused further neurosurgical treatment and 1 was treated with acetazolamide. Additionally, 1 patient who demonstrated normal ICP values, thus confirmed with NPH, underwent VP shunt implantation, while another 2 with similar characteristics refused further surgery. In our series the overall clinical complication rate after P-tel implantation was insignificant. The telemetric device is safely implanted via a rather simple procedure. In selected patients, it could provide long-term ICP recordings, which are necessary to confirm diagnosis and guide to the appropriate treatment. [ABSTRACT FROM AUTHOR]

Background: Craniopharyngioma is benign neoplasm thought to be caused by mal-development, which occurs in both children and adults in the sellar and suprasellar regions of the brain. Typical manifestations in adults are visual and endocrine system symptoms followed by signs and symptoms of increased intracranial pressure (i.e., headache). The management of this rare condition is complex and requires life-long surveillance by a multidisciplinary team of health-care professionals. Objective: To present a rare clinical presentation of craniopharyngioma mimicking nonspecific neck pain usually associated with cervicogenic headache recognized by a physiotherapist in a direct access setting as a condition requiring medical referral. Case Presentation: This case report describes the history, examination findings, and clinical reasoning used in the initial examination of a 33-year-old female with neck pain and cervicogenic headache as chief complaints. Several key indicators in the patient presentation warranted further and urgent investigation: 1) the recent onset of a "new-type" headache; 2) the phenotype headaches change; 3) the rapid progression of the symptoms; 4) the presence of associated neurological signs and symptoms; and 5) the worsening of the symptoms during Valsalva-like activities. The decision was made to refer the patient for further evaluation. An MRI revealed a craniopharyngioma. After a surgical removal of the tumor mass, the patient participated in a rehabilitation program and reached a full recovery after 6 months. Conclusion: This case report highlights the need of more research regarding red flags and warning signs during examination of in the head-neck region, and the central role of primary care clinicians such as physiotherapists in differential diagnosis of life-threatening conditions. [ABSTRACT FROM AUTHOR]

Although intraperitoneal chemotherapy (IPC) has evolved into an established treatment modality for patients with peritoneal metastasis (PM), drug penetration into tumor nodules remains limited. Drug transport during IPC is a complex process that depends on a large number of different parameters (e.g. drug, dose, tumor size, tumor pressure, tumor vascularization). Mathematical modeling allows for a better understanding of the processes that underlie drug transport and the relative importance of the parameters influencing it. In this work, we expanded our previously developed 3D Computational Fluid Dynamics (CFD) model of the drug mass transport in idealized tumor nodules during IP chemotherapy to include realistic tumor geometries and spatially varying vascular properties. DCE-MRI imaging made it possible to distinguish between tumorous tissues, healthy surrounding tissues and necrotic zones based on differences in the vascular properties. We found that the resulting interstitial pressure profiles within tumors were highly dependent on the irregular geometries and different zones. The tumor-specific cisplatin penetration depths ranged from 0.32 mm to 0.50 mm. In this work, we found that the positive relationship between tumor size and IFP does not longer hold in the presence of zones with different vascular properties, while we did observe a positive relationship between the percentage of viable tumor tissue and the maximal IFP. Our findings highlight the importance of incorporating both the irregular tumor geometries and different vascular zones in CFD models of IPC. [ABSTRACT FROM AUTHOR]

Introduction: Vestibular schwannomas (VS) account for approximately 85% of tumors in the cerebello-pontine angle, with a lifetime incidence of approximately 1 in 1000. Most are sporadic, with approximately 5% related to the tumor predisposition syndrome Neurofibromatosis Type 2 (NF2). The mainstays of management strategies are: observation, surgery, radiosurgery/radiotherapy and, for patients with NF2 and rapidly growing tumors or deteriorating neurologic function the targeted therapy bevacizumab. While morbidity and mortality rates related to treatment of VS have improved dramatically over the last decades, there are still significant improvements that could be made, in particular with regards to long-term facial nerve and hearing outcomes. Areas covered: The epidemiology and diagnosis of VS are discussed, followed by the different management strategies and outcomes of those for both sporadic and NF2 related tumors. An extensive literature review has been performed to inform this review article using PubMed and Google Scholar. Expert commentary: The future direction of VS management lies in obtaining longer-term follow-up data for patients with treated VS, and in improved understanding of cellular pathways and targeted therapies. [ABSTRACT FROM PUBLISHER]

A case of delayed spinal adamantinomatous craniopharyngioma recurrence is presented. A 54-year-old male patient was admitted in our Emergency Department complaining of urinary disorders and leg pains. He underwent surgical removal of intraventricular craniopharyngioma 12 years previously. On MR imaging a well-circumscribed intradural cistyc mass at the T12 level was reavealed. A T11 and T12 laminotomy was performed and total removal of the tumour was achieved. Histology examination showed adamantinous craniopharyngioma. The authors believe that this represents the third case described of spinal craniofaryngioma recurrence and the first involving the dorsal spine. [ABSTRACT FROM AUTHOR]

The article presents information on the proceedings of the 145th Meeting of the Society of British Neurological Surgeons. This meeting was held at Manchester, England on September 22-24, 2004. The research paper "Hearing Changes in Non-Enlarging Conservatively Managed Vestibular Schwannomas," presented at the meeting challenges the assumption that hearing will remain static in non-enlarging vestibular schwannomas, and therefore justify managing them expectantly as a means to preserve hearing. 1308 vestibular schwannomas referred to the senior author since 1977 were analysed to identify tumours treated conservatively.