Acta neurochirurgica
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Acta neurochirurgica · Aug 2010
Review Case ReportsAcute intracranial hypertension and shunt dependency following treatment of intracranial arachnoid cyst in a child: a case report and review of the literature.
Arachnoid cysts are developmental anomalies that represent 1% of all intracranial space occupying lesions. Treatment of symptomatic cases may include shunting of the cyst or an open fenestration of it, among other less acceptable surgical procedures. ⋯ We present a case of the development of an acute intracranial hypertension during cysto-peritoneal shunt malfunction in a child. We describe the possible mechanism of these phenomena and, based on this report and by reviewing other case series in the literature, we raise the possibility that acute increase in intracranial pressure and the development of shunt dependency, although rare, are important complications of shunting an arachnoid cyst.
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Acta neurochirurgica · Aug 2010
Review Meta AnalysisSurgery for extratemporal nonlesional epilepsy in adults: an outcome meta-analysis.
To better evaluate surgery for extratemporal lobe epilepsy (ETLE) in adults, we conducted a meta-analysis of previous studies that analyzed postoperative seizure outcomes for ETLE. ⋯ This meta-analysis confirms the findings of other centers: ETLE surgical outcomes are less desirable than those for temporal lobe epilepsy. None of the factors studied in adults showed significant association with outcome. Contrary to some reports, shortening the duration of epilepsy by pursuing surgery as early as possible also does not appear to improve outcomes. The creation of standard protocols among epilepsy centers is needed to allow for a detailed evaluation of outcomes across different centers and, ultimately, to better assess the factors associated with improved outcomes.