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Abstract Background Causes of extrahepatic portal vein obstruction include abdominal surgeries such as pancreaticoduodenectomy. We improved jejunal variceal bleeding due to extrahepatic portal vein occlusion after pancreaticoduodenectomy, by shunting of the testicular vein. Case presentation A 72-year-old man was diagnosed with extrahepatic bile duct cancer and underwent subtotal stomach-preserving pancreaticoduodenectomy 5 years ago. No postoperative complications occurred, adjuvant chemotherapy using gemcitabine hydrochloride was performed, and the patient remained recurrence-free. One year and 6 months post-operation, extrahepatic portal vein stenosis appeared, but no recurrence was noted. However, 4 years and 6 months later, recurrent gastrointestinal bleeding occurred, and the patient was diagnosed with an extrahepatic portal vein obstruction. Double-balloon enteroscopy showed capillary dilatation and varicose veins in the hepaticojejunostomy region, and venous bleeding from collateral blood vessels was diagnosed. A superior mesenteric vein to the right testicular vein shunt operation was performed, following which the gastrointestinal bleeding disappeared, and the anemia improved. Although transient hepatic encephalopathy occurred, conservative treatment relieved it. Double-balloon enteroscopy confirmed the disappearance of abnormal blood vessels. Conclusions A portosystemic shunt operation using the right testicular vein effectively relieved refractory variceal bleeding around the hepaticojejunostomy site in the jejunum due to an extrahepatic portal vein obstruction after pancreaticoduodenectomy.

Background: Causes of extrahepatic portal vein obstruction include abdominal surgeries such as pancreaticoduodenectomy. We improved jejunal variceal bleeding due to extrahepatic portal vein occlusion after pancreaticoduodenectomy, by shunting of the testicular vein. Case presentation: A 72-year-old man was diagnosed with extrahepatic bile duct cancer and underwent subtotal stomach-preserving pancreaticoduodenectomy 5 years ago. No postoperative complications occurred, adjuvant chemotherapy using gemcitabine hydrochloride was performed, and the patient remained recurrence-free. One year and 6 months post-operation, extrahepatic portal vein stenosis appeared, but no recurrence was noted. However, 4 years and 6 months later, recurrent gastrointestinal bleeding occurred, and the patient was diagnosed with an extrahepatic portal vein obstruction. Double-balloon enteroscopy showed capillary dilatation and varicose veins in the hepaticojejunostomy region, and venous bleeding from collateral blood vessels was diagnosed. A superior mesenteric vein to the right testicular vein shunt operation was performed, following which the gastrointestinal bleeding disappeared, and the anemia improved. Although transient hepatic encephalopathy occurred, conservative treatment relieved it. Double-balloon enteroscopy confirmed the disappearance of abnormal blood vessels. Conclusions: A portosystemic shunt operation using the right testicular vein effectively relieved refractory variceal bleeding around the hepaticojejunostomy site in the jejunum due to an extrahepatic portal vein obstruction after pancreaticoduodenectomy. [ABSTRACT FROM AUTHOR]

Abstract Objectives Due to increased number of patients suffering from hydrocephalus (HCP) and lack of data concerning volumetric changes after shunting operations, this study aims to assess the volumetric changes in brain ventricles after successful ventriculoperitoneal (VP) shunt surgery in correlation with clinical improvement. Patient and methods This study included 20 patients; all of them are below the age of 2 years. All the patients had hydrocephalus, were treated surgically with VP shunts, and have clinically improved over the period of study. We measured the volumetric changes radiologically using the fronto-occipital horn ratio (FOHR) over a period of 6 months postoperatively. Results The frontal and occipital horn ratio was calculated in all these patients both pre and postoperatively. There was a significant radiological improvement in the majority of children after the shunt operation. One month postoperatively, the FOHR decreased to about 85% of its preoperative value in average. The FOHR was found to be significantly improving with time over a period of 6 months reaching 63% of its preoperative value. Conclusion Successful treatment of HCP in infants via VPS seems to be of benefit in decreasing the ventricular size gradually to a near normal FOHR with clinical improvement.

Objective: To evaluate the effectiveness and safety of microsurgical gonadal-inferior epigastric vein anastomosis for the treatment of the nutcracker phenomenon (NCP) associated with left gonadal vein varices with reflux. Methods: Thirty-five patients with NCP associated with left gonadal vein varices with reflux diagnosed in our hospital from June 2016 to June 2018 were included. All patients underwent a shunt operation consisting of microsurgical gonadal-inferior epigastric vein anastomosis, and the patients were followed up for 1 year. Results: All patients were successfully operated on, with an average operation time of 96.5 ± 12.3 min. After a 1-year follow-up, the symptom of gross hematuria disappeared in 3 patients (including 1 woman). For the other 32 patients, the sperm concentration (27.43 ± 8.68 × 106/ml) and motility (33.06 ± 4.27%) postoperatively were significantly higher than that preoperatively (16.21 ± 6.43 × 106/ml and 23.48 ± 4.43%, respectively) (P < 0.05); among these patients, 2 had natural pregnancies with their spouses. The peak velocity (PV) at the aortomesenteric portion of the left renal vein (LRV) and the PV ratio between the aortomesenteric and hilar portion of the LRV significantly decreased after surgery (117.9 ± 30.4 cm/s vs 76.6 ± 18.5 cm/s; 7.3 ± 0.7 vs 4.1 ± 0.4). Two patients had complications of mild hydroceles requiring no intervention, and no major complications were observed during and after surgery. Conclusion: Our results suggest that the microsurgical gonadal-inferior epigastric vein anastomosis is both effective and safe to treat patients with gonadal varicose veins caused by the nutcracker phenomenon. [ABSTRACT FROM AUTHOR]

Objectives: Due to increased number of patients suffering from hydrocephalus (HCP) and lack of data concerning volumetric changes after shunting operations, this study aims to assess the volumetric changes in brain ventricles after successful ventriculoperitoneal (VP) shunt surgery in correlation with clinical improvement. Patient and methods: This study included 20 patients; all of them are below the age of 2 years. All the patients had hydrocephalus, were treated surgically with VP shunts, and have clinically improved over the period of study. We measured the volumetric changes radiologically using the fronto-occipital horn ratio (FOHR) over a period of 6 months postoperatively. Results: The frontal and occipital horn ratio was calculated in all these patients both pre and postoperatively. There was a significant radiological improvement in the majority of children after the shunt operation. One month postoperatively, the FOHR decreased to about 85% of its preoperative value in average. The FOHR was found to be significantly improving with time over a period of 6 months reaching 63% of its preoperative value. Conclusion: Successful treatment of HCP in infants via VPS seems to be of benefit in decreasing the ventricular size gradually to a near normal FOHR with clinical improvement. [ABSTRACT FROM AUTHOR]

With the aim to analyze the transient transformation of track circuit between the normal operation and shunt operation, this paper establishes the model of shunt operation of track circuit in the complex frequency domain, obtains the expression of current traveling wave at the receiving end in the complex frequency domain, and, on this basis, and acquires the numerical solution in the time domain by FFT & IFFT in conjunction with quotient-difference (Q-D) algorithm. Taking the steady state of circuit in normal operation and shunt operation as the state of zero moment of track circuit, the author solves the transient transformation between the normal operation and shunt operation. Finally, the EMTP model of shunt operation is established to prove the correctness of the transient analysis results. This research lays a solid theoretical basis for analyzing the shunt operation of track circuits by transient analysis [ABSTRACT FROM AUTHOR]

Objectives There is no accurate test for diagnosing normal pressure hydrocephalus or for screening for patients who will benefit from shunt surgery. Additional tests, such as cerebrospinal fluid tap test (CSF-TT), are often used in practice to provide further predictive value in detecting suitable patients for shunting. We performed a systematic review of the literature to evaluate the CSF-TT's effect on the outcome of main symptoms and on validity parameters in screening patients suitable for shunting. Methods In February 2015 we searched electronic databases from their inception to the current date, using the following key words: normal pressure hydrocephalus, idiopathic normotensive hydrocephalus, shunt operation, CSF tap test, predictive value, validity. The search retrieved 8 articles explicitly addressing the topic. Results There was a very high positive predictive value of CSF-TT: 92% (range from 73% to 100%) but a low negative predictive value: 37% (18%–50%). Also, the CSF-TT has high specificity: 75% (33%–100%) but average sensitivity: 58% (26%–87%). The overall accuracy of the test was 62% (45%–83%). Conclusions This systematic review did not provide unambiguous validity of the CSF-TT in the screening of patients for shunting. The validity of the CSF-TT is good for patient inclusion for shunting due to the fact that the positive response to the test is very reliable. Unfortunately, the negative response to the test does not reliably make these patients ineligible for shunting. Further studies are needed to improve and standardize the methodology in order to optimize the detection power of the test. [ABSTRACT FROM AUTHOR]

Subdural fluid collections (SFC) are characteristic complications of shunting for idiopathic normal pressure hydrocephalus (iNPH). This report presents two shunted iNPH patients with clinically silent postoperative SFC, detected after abnormal neuropsychological findings. These cases highlight the value of neuropsychological assessment in the routine postoperative assessment of iNPH. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To present a new approach using a shunt operation for the management of nutcracker phenomenon presenting as left varicocele in adolescent patients. Materials and methods: 12 adolescent patients with the nutcracker phenomenon presenting as left varicocele underwent a shunt operation consisting of anastomosis of the proximal part of the spermatic vein and inferior epigastric vein to lower the left renal vein (LRV) pressure. A simple ligation of the left spermatic vein was then used to repair the varicocele. Results: 12 patients underwent surgery, and symptoms of hematuria, proteinuria, scrotum discomfort, and flank pain disappeared post surgery in all patients. Patients were followed for 24–72 months (mean 48 months). The diameters of the proximal LRV and the peak velocities in the aortomesenteric portion of the LRV were significantly decreased after surgery (p < 0.001). Left testicular volume significantly increased after surgery. One patient had recurrence of the left varicocele and one adolescent had minimal hydrocele requiring no intervention. No major complications were observed during and after surgery. Conclusion: Anastomosis of the proximal part of the spermatic vein and inferior epigastric vein is an efficacious and safe surgical approach for the management of nutcracker phenomenon presenting as left varicocele in adolescents. [Copyright &y& Elsevier]

Introduction: Hemorrhage from jejunal varices formed at the site of Roux-en-Y choledochojejunostomy is rather rare, and no guidelines have so far been established for its treatment. This report presents the cases of 2 patients with jejunal varices formed at the site of choledochojejunostomy that were treated using different methods. An obstruction of the extrahepatic portal vein resulted in massive gastrointestinal bleeding in both cases Case 1: A 59-year-old male developed jejunal varices at the site of choledochojejunostomy. Multidetector computed tomography showed that the source of bleeding was located in the small intestine near portojejunal varices. The jejunal vein supplying the afferent loop was embolized using interventional radiology. There was no evidence of liver dysfunction or rebleeding after the embolization Case 2: A 79-year-old female developed jejunal varices at the site of choledochojejunostomy. Abdominal angiography could not detect the source of bleeding, and hence, a mesocaval shunt operation was performed. [ABSTRACT FROM AUTHOR]

We investigated the association between the degree of deformation of the brain before shunt operation and improvement of gait and cognitive impairment after shunt operation in 16 patients with idiopathic normal pressure hydrocephalus (iNPH). We evaluated gait and cognitive impairment and measured the cerebrospinal fluid volume in the ventricles/sylvian fissure (vVS) and the subarachnoid space at high convexity/midline areas (vHCM) using MR images with voxel-based morphometry before and 3 months after shunt operation. We used the ratio of vVS to vHCM (vVS/vHCM) as an index of the severity of brain deformation. After shunt operation, improvements were observed in gait, as shown by the Timed Up and Go (TUG) test and 10-meter reciprocating walking test (WT), and in cognitive function, as shown by the Mini-Mental State Examination, Alzheimer Disease Assessment Scale, Frontal Assessment battery (FAB), and Trail Making test A (TMT-A). The vVS/vHCM ratio was negatively correlated with improvement of the FAB, TMT-A and TUG. Preoperative vVS/vHCM was not significantly correlated with preoperative clinical assessments. The rate of change of vVS/vHCM was positively correlated with improvement in the WT. The improvements of gait and cognitive function were larger in iNPH patients with milder deformation of the brain before shunt operation. Copyright © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Secondary craniosynostosis rarely develops within several months in infants or children after shunt operations in early infancy. However, conventional operations (CO) such as fronto-orbital advancement and total skull reshaping have not been efficient enough to expand the intracranial volume in children with secondary craniosynostosis. Recently, distraction osteogenesis (DO) was reported to be effective in treating most craniosynostosis cases. Methods: We compared 9 children treated with DO and 3 children treated with CO who developed secondary craniosynostosis after shunt operation in early infancy. We measured the preoperative and follow-up head sizes with regard to head circumference, cephalometric intracranial volume, and intracranial volume estimated from the 3-dimensional computed tomogram. Results: The mean intracranial volumes expanded by 10.5% in the DO group 1 month after surgery and by 13.1% in the CO group on the immediate postoperative day. Further expansion was observed 6 months postoperatively, i.e. 10.3 and 4.7% in the DO and CO groups, respectively. Operation time and anesthesia time were significantly shorter in DO compared to CO patients, and the volumes of the blood transfusions were also less for DO patients. Conclusion: We suggest that DO is probably more efficient and safer than CO in expanding the intracranial volume in children with secondary craniosynostosis. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Selected normal pressure hydrocephalus (NPH) patients cannot be treated by shunt operation because of the procedure’s high complication rate. We have treated cases in which prolonged clinical improvement of NPH was experienced after one or two lumbar punctures (LPs). We evaluated the predictors of prolonged improvement of NPH symptoms by repeated LP. Thirty-one NPH patients were retrospectively evaluated (age 72.5 ± 5.8 years). Gait disturbance, urinary incontinence, and cognitive impairment were semiquantified. We divided the patients into three groups (non-responders, temporary responders, and prolonged responders) according to their responses after LP. We analyzed the characteristics of the groups. Gait disturbance (p = 0.046) and urinary incontinence (p = 0.040) scores and total NPH symptom score (p = 0.007) after cerebrospinal fluid drainage were more significantly improved in prolonged responders than in temporary responders. On multiple logistic regression analyses, total NPH score improvement was the only predictor of the prolonged responders (p = 0.03, odds ratio 0.148). Our study showed that some NPH patients could maintain favorable courses for at least 1 year after LP without shunt operation. Repeated LP could be an alternative treatment in selected NPH patients. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The high rate of overdrainage, by using low-pressure valves, is a loss suffered and accepted to get a good outcome in the treatment of idiopathic normal-pressure hydrocephalus (iNPH) patients. Can a programmable gravity-assisted valve offer a solution to deal with this problem optimizing the outcome?In a prospective follow-up study conducted in the Neurosurgical Department of the Unfallkrankenhaus Berlin, in the time between June 2004 and July 2005, 34 iNPH patients underwent shunt surgery using the new programmable gravity-assisted valve (ProGAVAesculap). These patients were followed up after 6 months and, again, after12 months.The course of the symptoms of iNPH patients correlates with the opening pressure of the valve. The controlled adjustment of the programmable valve opening pressure in steps of 20 to 30 mm H2O steps from an initial 100 to 70 and finally to 50 mm H2O, allows an optimal adaptation of the cerebrum in the new pressure environment and reduces the overdrainage rate.The advantage of the new programmable gravity-assisted valve (ProGAVAesculap) is the resistance to external magnetic fields causing otherwise the misadjustment of programmable valves and in case of reading the adjusted opening pressure by using a complementary device, without exposing the patient to a skull x-ray. The disadvantage lies in the difficult early postoperative (1 to 10 d postoperative) adjustment in 18% of the implanted valves. From the clinical point of view, the programmable gravity-assisted valve (ProGAVAesculap) is an indispensable development in the valve manufactory technique, offering a new standard in the management of iNPH. [ABSTRACT FROM AUTHOR]

The goal of this study was to determine whether hydrostatic valves are superior to conventional differential-pressure shunts in patients with normal-pressure hydrocephalus (NPH) with regard to the postoperative results of treatment and possible complications. From September 1997 to January 2002, 60 patients with idiopathic NPH were treated by surgical implantation of a hydrostatic valve (Miethke dual-switch valve [M-DSV]) at the Unfallkrankenhaus Berlin. The results of the clinical examination, the intrathecal infusion test, and the cerebrospinal tap test were used as aids in the decision-making process regarding the shunt operation. In a prospective study, the clinical examination and a computed tomography scan were carried out in all patients before surgery, after surgery, and 1 year after the operation. One year after the shunt operation, the clinical picture was very good for 33% of the patients, good for 33%, satisfactory for 17%, and poor for 17%. Three dislocations (5%) of ventricular or abdominal catheters and 3 valve infections were found as valve-independent complications. As valve-dependent complications, underdrainage was found in 4 patients (7%) and radiologic signs of overdrainage were found in 2 patients (3%), whereas 1 patient (1.7%) showed symptomatic overdrainage. At 20%, the rate of postoperative complications is still relatively high. The setting pressure of the M-DSV did not correlate with the postoperative results of treatment. According to our experience, hydrostatic M-DSVs are superior to conventional differential-pressure shunts without an additional gravity unit, especially with regard to the treatment of patients with idiopathic NPH, in the postoperative results of the treatment and the incidence of possible complications. With differential diagnosis and therapy, clinical improvement can be achieved for 83% of such patients. [ABSTRACT FROM AUTHOR]

: ObjectiveEspecially in patients with normal pressure hydrocephalus (NPH), conventional differential-pressure valves are known to create nonphysiological negative intraventricular pressure values (IVP) when the patient moves into the upright position, with the consequence of numerous, sometimes severe, complications. The recently presented gravitational devices promise improvement, primarily in respect to this disadvantage.: MethodsIn a prospective multicenter study the new Miethke dual- switch valve (DSV) has been implanted in 128 patients with NPH. The patients have been assessed before operation, at discharge, and re-evaluated 6 to 9 months after surgery. The technical principle of the new device is presented.: ResultsThe clinical follow-up showed excellent results in 63% of the patients, satisfactory results in 16%, and a bad outcome in 21% of the cases. The infection rate was 5%; the rate of mechanical complications including overdrainage and dislocations has been in total 9%, and underdrainage was suspected in 7 cases. The outcome correlated with the preoperative severity of NPH. Despite the clinical outcome, the computed tomography scans showed only minimal or no reduction of the ventricular size in the majority of cases. We found a valve-related rate of overdrainage of 2.5%, which is clearly lower than results of comparable series in the literature.: ConclusionThe clinical course of patients suffering from NPH is mainly influenced by the stage of the disease, the time of beginning of the therapy, and the gravitational function of the implanted device. Based on our clinical experiences with the Miethke dual-switch valve (MD-SV), we underscore the advantages of this valve for the treatment of hydrocephalus, especially for patients with NPH. [Copyright &y& Elsevier]

Despite emerging knowledge of over 40 years, the postoperative results after shunt implantations in patients diagnosed for normal-pressure hydrocephalus (NPH) have not improved significantly in the last decade. For this reason, predictors have to be identified in order to preoperatively predict the course of disease. From 1982 to 2000, we examined in a prospective study 200 patients diagnosed for NPH. Of the patients who were surgically treated by a shunt implantation we could re-examine 155 (78%) in a mean time interval of 7 months after operation. The NPH was graduated according to the results of the intrathecal infusion test in an early state NPH (without brain atrophy) and late state NPH (with brain atrophy). In the study we focused our attention on the possible predictors: patient’s age, length of disease, clinical signs – like gait ataxia, dementia and bladder incontinence, etiology idiopathic/secondary as well as implanted valve type and the value of resistance to cerebrospinal fluid outflow. To measure the outcome we used the NPH recovery rate, as statistical test the χ[sup 2] according to Pearson. In 80 patients with an early stage NPH (without cerebral atrophy) and a short course of disease (<1 year), slightly distinct dementia and an implanted Miethke Dual-Switch valve were significant predictors for a positive postoperative outcome. The outflow resistance measured in the intrathecal infusion test showed only a minimal relevance for the outcome. Those 75 patients with a late state NPH (with cerebral atrophy) had a better outcome when dementia was not present, the outflow resistance was >20 mm Hg·min/ml, the CSF tap test was positive and a Miethke Dual-Switch valve was implanted. Copyright © 2004 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Copyright of Klinische Neuroradiologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The intrathecal infusion test is a reliable method for diagnosing normal-pressure hydrocephalus (NPH). Methods: Between May 1982 and January 1997, we investigated 200 patients suspected of having NPH by carrying out an intrathecal infusion test with a constant-flow technique. The resistance to cerebrospinal fluid outflow in the intrathecal infusion test was the main criterion for grouping patients into those with NPH or those with cerebral atrophy. A further differentiation into early stage and advanced stage was made by measuring the compliance, this being the secondary criterion. Results: In 107 patients (54%), the diagnosis of NPH could be confirmed. Of these, 102 patients (95%) underwent a shunt operation. Graduation of NPH and cerebral atrophy following the results of the infusion test at an early stage and an advanced stage allows prognostic evaluations about the course of disease to be made. Patients with NPH at an early stage reported an improvement of their symptoms in the follow-up after a shunt operation in 65% of cases, while 50% of those with advanced-stage NPH reported improvement. Conclusion: The computer- aided infusion test allows a reliable differentiation between patients with NPH and those with cerebral atrophy.Copyright © 2001 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Summary Background. This study was conducted to investigate the usefulness of intracranial cerebrospinal fluid (CSF) volume measurement using MR-based methods in the management of patients with normal pressure hydrocephalus (NPH). Methods. The study group comprised 19 patients with NPH who showed a favorable outcome after ventricular shunting, 15 normal volunteers (NV), and 15 patients with cerebrovascular disease (CVD). A 3D-fast asymmetric spin echo MR imaging sequence and the region-growing method were used to extract the CSF space from MR images. Ventricular volume (VV) and intracranial CSF volume (ICV) were measured and the VV/ICV ratio was calculated in each case. In NPH patients, the CSF volume was measured again after shunting. Findings. The mean VV and VV/ICV ratio in the NPH group (91.1 mL and 45.2%, respectively) were significantly (p<0.01) higher than those in the NV group (26.5 mL and 13.7%) and in the CVD group (44.5 mL and 17.8%). On the other hand, mean ICV values were not significantly different among the three groups. The VV was markedly decreased postoperatively (mean -40.7%), whereas the ICV was unchanged, resulting in a marked reduction in the VV/ICV ratio (mean -39.3%). Interpretation. These results suggest that patients with NPH have a unique intracranial CSF distribution, with an enlarged VV and a slightly increased ICV, resulting in a high VV/ICV ratio. Shunting led to dramatic improvement in our patients. It is likely that CSF measurement can provide valuable information in the management of patients with NPH. [ABSTRACT FROM AUTHOR]

Thirty-eight patients with normal pressure hydrocephalus were examined by CT before and after a ventriculo-peritoneal shunt operation. Evans ratio, periventricular hypodensity and width of hemispheric sulci, sylvian fissures, cella media, temporal horns and third and fourth ventricle were examined. Twenty-eight patients improved after the operation while 10 were unchanged (non responders). Those patients who improved had more often enlarged third ventricle, enlarged temporal horns and normal sylvian fissures than those who did not improve. No single CT parameter or combination of CT parameters alone could identify responders and non-responders. The ventriculo-peritoneal shunt operation reduced ventricular size (Evans ratio, cella media width), abolished periventricular hypodensity and reduced width of the temporal horns and third ventricle in both responders and non-responders. Reduction of the width of the third ventricle correlated to clinical improvement. [ABSTRACT FROM AUTHOR]

We examined the changes in ornithine decarboxylase (ODC) immunoreactivity in the hydrocephalic cerebral cortex of HTX rats after decompression by shunt operation. The ODC immunoreactivity reached a very low level after the completion of cortical layer formation, and only faint staining was found on postnatal day (Pd) 11. The ODC immunoreactivity re-appeared after the shunt operation when the operation was done in the early days of life: the ODC immunoreactivity was first found on day 2 after shunting and persisted until day 8 after shunting. However, this was not apparent when the operation was not performed until Pd 14. The re-expression of ODC in hydrocephalic brain after shunting appears to cause resumption of the developmental process by relieving neurons from increased hydrostatic pressure. The dependence of ODC re-expression on the timing of the operation indicates that there may be a period of neocortical decompression that is critical for effective compensatory development, so that when delayed, decompression fails to re-activate the ODC-dependent development. [ABSTRACT FROM AUTHOR]

Copyright of Langenbecks Archiv fuer Chirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Langenbecks Archiv fuer Chirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)