Bruton’s tyrosine kinase (BTK) is involved in the regulation of B-cell growth, migration and adhesion. The importance BTK cell trafficking emphasized by clonal contraction proceeded lymphocytosis typical for enzyme inhibitor, ibrutinib, malignancies, including chronic lymphocytic leukemia (CLL). Here, we investigated leukemic a mouse model aggressive TCL1 CLL-like disease. Inhibiting ibrutinib reduced surface membrane (sm) levels CXCR4 but not CXCR5, CD49d other adhesion/homing receptors....

Corpus callosotomy and hemispherotomy are conventionally performed via a large craniotomy with the aid of microscope for children intractable epilepsy. Primary technical considerations include completeness disconnection blood loss. The authors describe an endoscopic technique through microcraniotomy these procedures.Four patients drop attacks 2 seizures related to neonatal stroke underwent complete corpus hemispherotomy, respectively. surgeries were 2- 3-cm precoronal microcraniotomy....

<i>Objective:</i> Exaggerated nocturnal intracranial pressure (ICP) dynamics are commonly observed in hydrocephalic children with a compromise of CSF compensatory reserve capacity. Successful shunting restores this cerebrospinal reserve. We used ICP overnight monitoring combined positional maneuvers complex suspected shunt malfunction for the assessment function. <i>Methods:</i> In 32 children, we performed 65 computerized recordings and 25 maneuvers. Baseline was...

The purpose of this article is to describe outcomes intrathecal baclofen therapy for 29 patients with cerebral palsy, focusing on impairments, functional limitations, and disability. Patients received individualized rehabilitation were followed up 24 months. primary outcome measures the Ashworth Scale skills caregiver assistance scales Pediatric Evaluation Disability Inventory (PEDI). scores significantly reduced ( P .0005). All areas improved. Comparing groups adults less than 18 years,...

Object Sagittal craniosynostosis is traditionally considered to be a surgical condition. Poor results of simple suturectomy follow from early reclosure the suture. A wider craniectomy or use interposing materials has not improved outcome. However, endoscopic supplemented with postoperative molding helmet shown good results. Because reunites within 8–12 weeks surgery, authors questioned if outcome was primarily related helmet. Methods In 4 patients whose families opted for calvarial...

Object. The authors of previous studies have suggested that connectivity within the cerebral cortex may be irreversibly altered by hydrocephalus. To examine connectivity-related changes directly, conducted a study in which they used an axonal tracer animal model infantile Methods. In five hydrocephalic kittens low-pressure ventriculoperitoneal (VP) shunts were placed 10 to 14 days after induction hydrocephalus intracisternal kaolin injections. Wheat germ agglutinin-conjugated horseradish...

P The authors describe their experience with endoscopic fenestration of suprasellar cysts followed by shrinkage coagulation the to restore anatomy in eight patients. Seven children ranging age from 8 months 4.5 years and one adult 24 were treated. Four presented megacephaly other patients malfunction a shunt that had been placed previously for hydrocephalus. Endoscopic cyst dome was performed lesion means coagulation. Follow-up studies included immediate late postoperative magnetic resonance...

<i>Objective:</i> To analyze the association of diverse cerebral anomalies in a series pediatric patients with cerebellar tonsillar ectopia. <i>Methods:</i> We reviewed medical records 60 children diagnosed Chiari type 1 malformation (CM1), these, 20 (11 boys and 9 girls; mean age 7.2 years, range 2–16 years) had an associated anomaly. Symptoms ectopia evolved over 12 months (range 3 to 4 years). Syringomyelia was present 5 cases. All underwent posterior fossa...

Implantation of ventricular catheters (VCs) to drain cerebrospinal fluid (CSF) is a standard approach treat hydrocephalus. VCs fail frequently due tissue obstructing the lumen via drainage holes. Mechanisms driving obstruction are poorly understood. This study aimed characterize histological features VC obstructions and identify links clinical factors. 343 with relevant data were collected from five centers. Each hole on was classified by degree after macroscopic analysis. A subgroup 54...

The aim of this study was the introduction a new linear ventricular measurement which has better correlation with volume than commonly used measurements, especially in chronically shunted patients small and/or asymmetrical ventricles. Ventricular volume, brain Evans ratio, Schierman index, cella media index and frontal occipital horn ratio were measured from CT scans 57 hydrocephalic 20 normal control children. Four groups identified regards to size symmetry (small, large, symmetrical...

Object Slit-ventricle syndrome (SVS) is a confusing description of presentations in patients with chronic shunt-treated hydrocephalus. These are prone to acute deterioration recurrent malfunction. The authors describe the clinical profile and management outcome using lumboperitoneal (LP) shunts this population patients. Methods Thirty-three slit ventricles malfunctions were converted LP (mean age 12 years). initial ventricular shunt was placed at mean 16.5 months. Ten had failed endoscopic...

Object Shunt infections and their management remain a clinically important problem in patients with hydrocephalus. The authors evaluated, comparison traditional parameters, C-reactive protein (CRP) blood/serum (S-CRP) cerebrospinal fluid (CSF; C-CRP) for its power to identify treat infected shunts. Methods On 84 different occasions, CSF blood samples from 59 children suspected of having shunt/CSF were obtained evaluated. An infection was proven by culture 35 evaluations. Values S-CRP...

Pediatric hydrocephalus is a devastating and costly disease. The mainstay of treatment still surgical shunting cerebrospinal fluid (CSF). These shunts fail at high rate impose significant burden on patients, their families society. relationship between clinical decision making shunt failure poorly understood multifaceted, but catheter occlusion remains the most frequent cause complications. In order to investigate factors that affect failure, we have established Wayne State University (WSU)...

Patients undergoing long-term shunt therapy following malfunction often present with acute neurological deterioration, high intracranial pressure (ICP), and yet small or slit ventricles. It is believed that low brain compliance prevents ventricle enlargement in such cases. To elucidate the underlying pathophysiology, authors estimated as a function of cerebrovascular distensibility 45 patients chronic therapy.The ICP pressure-volume index (PVI) were measured at end-tidal CO2 30 mm Hg (PVI30)...

Object In this single-center study, the authors examined clinical characteristics, risk factors, treatment strategies, and outcomes in patients with thrombosis associated ventriculoatrial (VA) shunts. Methods Inpatient outpatient charts of who underwent follow-up Hematology-Oncology Division at authors' institution whom developed secondary to a VA shunt placement were reviewed. A complete thrombophilia work-up was performed each patient, these records also Treatment including medical...

OBJECTIVE Cranial vault expansion is performed in pediatric patients with craniosynostosis to improve head shape. Another argument for performing total cranial reconstruction the potential reduction harmful effects of elevated intracranial pressure (ICP) that are associated craniosynostosis. Alternatively, molding helmets have been shown index (CI) sagittal synostosis without surgery. However, it unknown if use surgery contributes adverse changes ICP. The effect on ICP and CI was...

A subset of hydrocephalic patients with indwelling shunts become symptomatic when they are upright and active. Intracranial pressure (ICP) measurements in these have shown a significant drop the patient is return to normal levels supine. In 20 chronically shunted who previously had no siphon protection devices, ICP changes supine position were studied at time external ventriculostomy for treatment shunt infection. Our hypothesis was that might display rapid from fluid shifts occurring...

A rare case of delayed lateral rectus palsy in a patient following resection pineal lesion the sitting position is presented. Postoperative pneumocephalus common craniospinal surgical intervention position. The sixth cranial nerve frequently injured because its prolonged intracranial course. 13-year-old girl was evaluated for unremitting headaches. No focal deficits were demonstrated on neurological examination. Magnetic resonance imaging revealed cystlike region mass with peripheral...

To determine if eosinophils are activated to release the cationic proteins, eosinophil protein (ECP) and eosinophil-derived neurotoxin (EDN) in shunt obstruction, find out these proteins associated with ventriculoperitoneal failure.This was a prospective observational study carried 20-bed tertiary pediatric intensive care unit. Patients studied were children aged 0-18 years suspected malfunction requiring revision. No interventions performed. Cerebrospinal fluid (CSF) analyzed for cell count...