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1.
World Neurosurg ; 189: e204-e210, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38871287

RESUMO

OBJECTIVE: Hydrocephalus, a major complication in tuberculous meningitis (TBM) patients, often necessitates treatment via ventriculoperitoneal shunt (VPS). However, post-VPS, some patients develop a complication called contralateral isolated lateral ventricle (CILV), leading to persistent hydrocephalus symptoms. This study aims to evaluate cerebrospinal fluid (CSF) parameters in predicting CILV occurrence post-VPS in adult TBM patients. METHODS: A retrospective analysis was conducted, focusing on the relationship between preoperative CSF parameters and the development of CILV in 40 adult TBM patients who underwent VPS. The study compared CSF parameters from lumbar puncture after admission with those from ventricular CSF post-external ventricular drainage tube insertion. RESULTS: CILV was observed in 6 of the 40 patients following VPS. Statistical analysis showed no significant difference between the CSF parameters obtained via lumbar and ventricular punctures. Notably, the mean CSF glucose level in patients with CILV was significantly lower (1.92 mmol/L) compared to the non-CILV group (3.03 mmol/L). Conversely, the median adenosine deaminase (ADA) level in the CILV group was higher (5.69 U/L) compared to the non-CILV group (3.18 U/L). The optimal cutoff values for CSF glucose and ADA levels were 1.90 mmol/L and 4.80 U/L, respectively, with a sensitivity of 66.67% and 83.33% and a specificity of 88.24% and 79.41%. CONCLUSIONS: The study identified elevated ADA levels and decreased glucose levels in CSF as potential risk factors for CILV development in adult TBM patients post-VPS. These findings suggest the necessity for more tailored surgical approaches, in patients with altered CSF parameters to mitigate the risk of CILV.


Assuntos
Hidrocefalia , Ventrículos Laterais , Tuberculose Meníngea , Derivação Ventriculoperitoneal , Humanos , Hidrocefalia/cirurgia , Hidrocefalia/etiologia , Feminino , Masculino , Derivação Ventriculoperitoneal/efeitos adversos , Tuberculose Meníngea/líquido cefalorraquidiano , Tuberculose Meníngea/complicações , Adulto , Estudos Retrospectivos , Pessoa de Meia-Idade , Ventrículos Laterais/diagnóstico por imagem , Idoso , Adenosina Desaminase/líquido cefalorraquidiano , Adulto Jovem , Glucose/líquido cefalorraquidiano , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/líquido cefalorraquidiano , Punção Espinal/efeitos adversos
3.
World J Surg Oncol ; 15(1): 186, 2017 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-29041974

RESUMO

BACKGROUND: We investigated the functional status of adult supratentorial superficial low-grade glioma (ASS-LGG) after surgery and analyzed its relevant factors to guide the therapeutic strategy and improve the life quality of these patients. METHODS: Clinical materials from January 2008 to December 2010 in 104 adults with ASS-LGG were analyzed retrospectively. The follow-up period ranged from 6 months to 1.5 years. The logistic regression was used to evaluate the preoperative and postoperative variation of functional status in patients to disclose the relevant factors affecting postoperative functional status, such as age, gender, the duration of symptom, size and location of the tumor, hemisphere, resection degree, and tumor pathologic grade and preoperative Karnofsky performance status (Pre-KPS). RESULTS: Four out of nine candidate factors are related to the postoperative functional status. They are age less than 40 years, the size of tumor less than 5 cm in diameter, tumor located in the right hemisphere, and limited resection of tumor in the eloquent area. CONCLUSIONS: It seems more meaningful to evaluate the functional status of the patients with ASS-LGG on the basis of these clinical features, involving age, tumor size, location, and extent of resection.


Assuntos
Glioma/cirurgia , Avaliação de Estado de Karnofsky , Procedimentos Neurocirúrgicos/efeitos adversos , Qualidade de Vida , Neoplasias Supratentoriais/cirurgia , Adulto , Fatores Etários , Feminino , Seguimentos , Glioma/patologia , Humanos , Masculino , Gradação de Tumores , Procedimentos Neurocirúrgicos/métodos , Período Pós-Operatório , Prognóstico , Estudos Retrospectivos , Neoplasias Supratentoriais/patologia
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