Thesis (M.S.)--Brigham Young University. Dept. of Electrical and Computer Engineering, 2005. / Includes bibliographical references (p. 275-278).

No description available.

Hydrocephalus is a common neurological condition characterized by altered cerebrospinal fluid (CSF) flow that results in ventricular expansion due to an accumulation of CSF inside the cranial vault. It is the second most frequent congenital neurologic malformation, but it can manifest at any age, as it is associated with multiple acquired etiologies related to CSF blockage or impaired CSF absorbance. The type and severity of brain damage is dependent on the age of onset, the rate of ventricular enlargement, the magnitude of ventriculomegaly, and how near the impaired brain structure(s) is/are to the cerebral ventricles. The purpose of this thesis was to gain an understanding of potential pharmacological therapies for treating pediatric hydrocephalus that are aimed to supplement commonly used surgical procedures, such as ventricular shunting and endoscopic third ventriculostomy (ETV). In this endeavour, we experimentally induced hydrocephalus by injection of kaolin (aluminum silicate) into the cisterna magna of juvenile rats at 3 weeks age and ferrets at 2 weeks age to mimic the human condition in infants and children. Prior to drug testing, we characterized the ferret model of hydrocephalus and examined the behavioural, brain structural, cellular, and neurobiochemical changes associated with the condition. From there, we treated hydrocephalic rats for 2 weeks with a combination of antioxidant agents, including α-tocopherol, L-ascorbic acid, coenzyme Q10 (CoQ10), reduced glutathione, and reduced lipoic acid to determine if they showed any improvements compared to sham-treated hydrocephalic rats. Afterwards, we used MgSO4 to treat hydrocephalic ferrets for 2 weeks and compared their outcome to sham-treated hydrocephalic ferrets. In both experiments, the pharmacological therapies did not show any significant biochemical and neurological benefits, nor did the animals improve behaviourally compared to sham-treated animals. Overall, it is suggested that therapeutic benefits were not observed in these studies potentially because ventriculomegaly was not severe enough, the route and/or timing of treatment was not maximally effective, or these treatments should be supplemented with surgical interventions to determine their potential synergistic effects, which would be expected to be implemented in the clinical setting. In conclusion, surgical procedures for treating hydrocephalus are rife with complications, which adds to its morbidity and mortality, so it is important to investigate new therapeutic avenues to effectively treat and hopefully cure hydrocephalus one day. / October 2016

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Umeå : Univ., 2005. / Härtill 4 uppsatser.

Made available in DSpace on 2014-06-11T19:23:38Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-08-10Bitstream added on 2014-06-13T19:30:00Z : No. of bitstreams: 1 bim_c_me_ilha.pdf: 1476209 bytes, checksum: 92d61b304ec4091683a52eecacb4389c (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Hidrocefalia, também conhecida como “água no cérebro”, é uma condição médica que afeta adultos e crianças e pode ser causada por má formação congênita, anomalias cerebrais, tumores, inflamações, infecções, encefalite, hemorragia intracraniana, traumatismos e outros. A hidrocefalia pode ser seguida por aumento significativo da pressão intracraniana (PIC), que ocorre em razão do acúmulo excessivo do líquido cefalorraquidiano (LCR) nos ventrículos ou cavidades do cérebro, resultando em danos cerebrais permanentes e até em morte. Após o diagnóstico de hidrocefalia há poucas opções de tratamento, exceto cirúrgicas. O processo envolve a implantação de um cateter ventricular para controlar o fluxo de LCR que, geralmente, é drenado das cavidades intracranianas para outro lugar. A drenagem pode ser feita por diferentes métodos. A drenagem do LCR para um reservatório fora do corpo humano é um tratamento provisório, também conhecido como drenagem ventricular externa (DVE). Também é possível realizar um tratamento permanente implantando-se um “shunt”, a fim de promover a drenagem do líquor para outra cavidade corporal, sendo a cavidade abdominal a mais comum. Esse procedimento é chamado de drenagem ventricular interna (DVI). No presente trabalho, experimentos foram realizados com alguns tipos de válvulas unidirecionais de drenagem externa do LCR, a fim de verificar seus comportamentos quando submetidas a vários gradientes de pressão encontrados no organismo humano. Para isso, houve uma sondagem quanto à metodologia de estudo mais adequada para essa investigação, a fim de proporcionar maior segurança aos resultados obtidos nessa pesquisa e em trabalhos futuros / Hydrocephalus, also known as “water on the brain”, is a medical condition that affects both adults and children, and it can be caused by birth defects, brain abnormalities, tumors, inflammations, infections, encephalitis, intracranial hemorrhage, trauma and others. The hydrocephalus may be followed by a significant increase of the intracranial pressure (ICP) with occurs due to the excessive accumulation of cerebrospinal fluid (CSF) in the ventricles or cavities of the brain, this can result in permanent brain damage and even death. After the diagnosis of hydrocephalus, there are some options for treatment except surgical. The process involves the placement of a ventricular catheter to control the flow of CFS with, usually, is drained of the intracranial cavity for other place. The draining can be done by different methods. Draining the CSF into a bag outside the body human is a temporary treatment, also known as external ventricular drainage (EVD). It is also possible make a permanent treatment, in this case, a “shunt” system is placed in order to promote the drainage of CSF to another body cavity, and the abdominal cavity is one of the most common, this procedure is called internal ventricular drainage (IVD). In the present work experiments were performed with some types of one-way valves for external drainage of CSF, to verify their behavior when subjected to various pressure gradients found in human organism. Para isso houve uma sondagem quanto à methodology of study more appropriate for this investigation to provide greater security in results obtained in this work and future works

Orientador: Sérgio Said Mansur / Coorientador: Edson Del Rio Vieira / Banca: André Luiz Seixlack / Banca: Marcos Pinotti Barbosa / Resumo: Hidrocefalia, também conhecida como "água no cérebro", é uma condição médica que afeta adultos e crianças e pode ser causada por má formação congênita, anomalias cerebrais, tumores, inflamações, infecções, encefalite, hemorragia intracraniana, traumatismos e outros. A hidrocefalia pode ser seguida por aumento significativo da pressão intracraniana (PIC), que ocorre em razão do acúmulo excessivo do líquido cefalorraquidiano (LCR) nos ventrículos ou cavidades do cérebro, resultando em danos cerebrais permanentes e até em morte. Após o diagnóstico de hidrocefalia há poucas opções de tratamento, exceto cirúrgicas. O processo envolve a implantação de um cateter ventricular para controlar o fluxo de LCR que, geralmente, é drenado das cavidades intracranianas para outro lugar. A drenagem pode ser feita por diferentes métodos. A drenagem do LCR para um reservatório fora do corpo humano é um tratamento provisório, também conhecido como drenagem ventricular externa (DVE). Também é possível realizar um tratamento permanente implantando-se um "shunt", a fim de promover a drenagem do líquor para outra cavidade corporal, sendo a cavidade abdominal a mais comum. Esse procedimento é chamado de drenagem ventricular interna (DVI). No presente trabalho, experimentos foram realizados com alguns tipos de válvulas unidirecionais de drenagem externa do LCR, a fim de verificar seus comportamentos quando submetidas a vários gradientes de pressão encontrados no organismo humano. Para isso, houve uma sondagem quanto à metodologia de estudo mais adequada para essa investigação, a fim de proporcionar maior segurança aos resultados obtidos nessa pesquisa e em trabalhos futuros / Abstract: Hydrocephalus, also known as "water on the brain", is a medical condition that affects both adults and children, and it can be caused by birth defects, brain abnormalities, tumors, inflammations, infections, encephalitis, intracranial hemorrhage, trauma and others. The hydrocephalus may be followed by a significant increase of the intracranial pressure (ICP) with occurs due to the excessive accumulation of cerebrospinal fluid (CSF) in the ventricles or cavities of the brain, this can result in permanent brain damage and even death. After the diagnosis of hydrocephalus, there are some options for treatment except surgical. The process involves the placement of a ventricular catheter to control the flow of CFS with, usually, is drained of the intracranial cavity for other place. The draining can be done by different methods. Draining the CSF into a bag outside the body human is a temporary treatment, also known as external ventricular drainage (EVD). It is also possible make a permanent treatment, in this case, a "shunt" system is placed in order to promote the drainage of CSF to another body cavity, and the abdominal cavity is one of the most common, this procedure is called internal ventricular drainage (IVD). In the present work experiments were performed with some types of one-way valves for external drainage of CSF, to verify their behavior when subjected to various pressure gradients found in human organism. Para isso houve uma sondagem quanto à methodology of study more appropriate for this investigation to provide greater security in results obtained in this work and future works / Mestre

Orientador: Edmur Franco Carelli / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-15T06:09:57Z (GMT). No. of bitstreams: 1 Aquino_HumbertoBelemde_D.pdf: 2197081 bytes, checksum: cc5953d9effb8cb84ca28b6d43985315 (MD5) Previous issue date: 2009 / Resumo: Complicações infecciosas decorrentes do tratamento cirúrgico da hidrocefalia, através do implante de um sistema de derivação ventricular (SDV) permanecem como condição de grande desafio na prática diária do neurocirurgião, seja para adultos e crianças. Algumas estratégias cirúrgicas e clínicas são adotadas em todo o mundo, mas ainda não há consenso sobre qual estratégia poderia ser considerada a melhor. Prevenir a infecção parece ser a melhor opção, assim, discute-se a validade do uso rotineiro e rígido de protocolos pré, intra e pós-operatório, a avaliação dos possíveis fatores de risco para o desenvolvimento de uma infecção, a experiência do cirurgião, o meio ambiente cirúrgico e o tempo de cirurgia, o uso de antibióticos como profilaxia e mais recentemente o uso de cateteres impregnados com antibióticos. No entanto, a incidência para infecção de um SDV é considerada alarmante (1% a 40% com uma média de 8,5% a 10%), a morbidade e mortalidade são altas (30% a 40%), o tratamento requer um longo tempo de permanência hospitalar (mais de 3 semanas), apresenta um alto custo operacional, além de uma alta taxa de reinfecção ao redor de (26%). O objetivo do trabalho é apresentar uma pesquisa entre Neurocirurgiões Brasileiros, realizada através de um questionário, sobre o estado atual do tratamento das infecções em um sistema de derivação ventricular entre eles e suas variabilidades. Neurocirurgiões Brasileiros foram pesquisados através de um questionário eletrônico, via página oficial da Sociedade Brasileira de Neurocirurgia (SBN), via e-mail do autor, e questionários entregues pessoalmente em 2 grandes Congressos Brasileiros de Neurocirurgia no ano de 2007. O questionário apresentava um caso clínico hipotético como referência de infecção em um SDV e perguntas sobre critérios clínicos, laboratoriais e/ou radiológicos de infecção e cura e a estratégia de tratamento. Trezentos e trinta e sete respostas foram envolvidas na pesquisa, o que corresponde a (14,04%) de 2.400 Neurocirurgiões cadastrados Na SBN, na época da pesquisa. Os questionários foram analisados, interpretados e posicionados em ordem de preferência de respostas dos pesquisados em um banco de dados. É nossa impressão que há uma significante variabilidade de informações sobre o estado atual de tratamento das infecções de um SDV entre os Neurocirurgiões pesquisados e com tendências similares à literatura / Abstract: Infectious complications following surgical treatment of hydrocephalus with shunt implantation remains a very challenging condition in pediatric and adult neurosurgical practice. Some surgical strategies and clinical therapy have been used by many neurosurgical centers around the world but still now there isn't a consensus regarding what general strategy can be considered better. To prevent it seems to be the best option but. The literature discusses about protocols, risk factors, expertise of the surgeons, operating room environment, surgery time, antibiotic prophylaxis, antibiotic-impregnated shunts and specifics strategies of surgical treatment and antibiotics. The incidence ranging from 1% to 40% with an average of 8.5% - 15%, raised morbidity and mortality (40%), long hospital stay (more than 3 weeks), elevated costs and elevated rate of reinfection (26%). We presented a practice survey among Brazilian Neurosurgeons to know the current state of treatment strategies of shunt infections and variabilities. Brazilian neurosurgeons were surveyed by a questionnaire by Brazilian Neurosurgery Society (SBN) and questionnaires by personal e-mail and personally taken to and handed in two important Brazilian Neurosurgery Congresses (2007), about treatment strategy facing shunt infections and criteria used to define diagnosis and cure. About 337 questionnaires were evolved on the survey (14.04%) from the 2,400 neurosurgeons. All the questionnaires were analyzed, interpreted and inserted in the database and all answers were termed using at same literature words. It is our impression that there is a significant variability among the Brazilian Neurosurgeons surveyed, with tendencies and there is similarity with literature / Doutorado / Neurologia / Doutor em Ciências Médicas

Hydrocephalus can impact all areas of health, including physical, cognitive, and social-emotional functioning. The social-emotional health of children who have had surgery for their hydrocephalus is not well characterized. This study examined social-emotional and behavioral functioning using the Behavioral Assessment System for Children, Third Edition (BASC-3) and the Hydrocephalus Outcome Questionnaire (HOQ) in children aged 5-17 years old. BASC-3 parent report scores were compared to the BASC-3 normative sample using one-sample t-tests to evaluate overall social-emotional functioning. BASC-3 scores were correlated with the social-emotional domain of the HOQ using Pearson's r to determine if the HOQ accurately captures the social-emotional functioning of children with hydrocephalus in a neurosurgery setting. BASC-3 and HOQ scores of children with different etiologies of hydrocephalus were compared using one-way ANOVAs. Children with hydrocephalus of all etiologies had more difficulties with social-emotional functioning compared to normative populations, but there were no differences in functioning between etiologies. The social-emotional domain of the HOQ correlated more strongly with the BASC-3 than did the physical and cognitive domains. These results provide evidence that children who have had surgery for their hydrocephalus may be at increased risk of social-emotional and behavioral difficulties, but etiology may not be particularly helpful in predicting what kinds or degree of difficulty. This study also supports the content and divergent validity of the social-emotional domain of the HOQ.

Thirty-six myelomeningocele children with hydrocephalus (between 9-16 years of age) were evaluated on a battery of neuropsychological tests and behavioural measures. The children obtained a FSIQ on the WISC-R of greater than 60 and all were attending school on a regular basis. Results showed that the myelomeningocele children, as a group, performed as well as the normative sample on measures of auditory comprehension, fine motor speed, accuracy on a visuomotor speeded task, stereognosis, and single-word reading. Although there was substantial variability within the myelomeningocele sample in terms of level of cognitive performance, as a group, with the exception of the above mentioned measures, they performed below the level expected for their age on the remaining measures in the neuropsychological test battery (83.63% of tests administered). / Graduate