Benign external hydrocephalus: a review, with emphasis on management

Benign external hydrocephalus in infants, characterized by macrocephaly and typical neuroimaging findings, is considered as a self-limiting condition and is therefore rarely treated. This review concerns all aspects of this condition: etiology, neuroimaging, symptoms and clinical findings, treatment, and outcome, with emphasis on management. The review is based on a systematic search in the Pubmed and Web of Science databases. The search covered various forms of hydrocephalus, extracerebral fluid, and macrocephaly. Studies reporting small children with idiopathic external hydrocephalus were included, mostly focusing on the studies reporting a long-term outcome. A total of 147 studies are included, the majority however with a limited methodological quality. Several theories regarding pathophysiology and various symptoms, signs, and clinical findings underscore the heterogeneity of the condition. Neuroimaging is important in the differentiation between external hydrocephalus and similar conditions. A transient delay of psychomotor development is commonly seen during childhood. A long-term outcome is scarcely reported, and the results are varying. Although most children with external hydrocephalus seem to do well both initially and in the long term, a substantial number of patients show temporary or permanent psychomotor delay. To verify that this truly is a benign condition, we suggest that future research on external hydrocephalus should focus on the long-term effects of surgical treatment as opposed to conservative management

Lipid peroxidation and antioxidant status in experimental animals: Effects of aging and hypercholesterolemic diet

Effects of aging and hypercholesterolemic diet on lipid peroxidation and antioxidant status were investigated in rats. The rats were divided into four groups of ten: Group I; young rats receiving standard lab chow; Group II; young rats on hypercholesterolemic diet (0.4 g/rat/day); Group III; aged rats receiving standard lab chow; Group IV; aged rats on hypercholesterolemic diet (0.4 g/rat/day). Plasma lipid peroxidation end product level was determined as thiobarbutiric acid reactive substances (TEARS). Plasma cholesterol concentration was analyzed by a kinetic enzymatic method. Erythyocyte superoxide dismutase (CuZn SOD), glutathione peroxidase (GSH Pr) and glutathione (GSH) levels were determined spectrophotometrically. Cholesterol values were found to be significantly high (p p > 0.02) and GSH (p p > 0.02) was observed in aged rats. In young rats hyperchlesterolemic diet caused a significant increase in both GSH and CuZnSOD levels. Our results indicate an imbalance between radical production and destruction in favour of prooxidant conditions in the young rats and the induction by hypercholesterolemic diet of the antioxidative response in erythrocytes. (C) 1997 Elsevier Science B.V

The effect of ginkgo biloba glycoside on the blood viscosity and erythrocyte deformability

In this study, we investigated the effect of ginkgoglycoside in two different doses (19.2 mg/day and 28.8 mg/day) on blood viscosity and erythrocyte deformability in 27 patients suffering from cerebrovascular insufficiency. The patients were divided into two groups randomly consisting of 13 and 14 patients respectively. Both groups received 28.8 mg/day ginkgoglycoside between the 1st and 15th day. The first group received the same dose until the end of the 30th day, whereas the dose administrated to the second group was reduced to 19.2 mg/day. In the first group, during 30 days a significant decrease in blood viscosity and a significant increase in erythrocyte deformability were observed. In the second group on the other hand, after dose reduction, the effect of the drug on blood viscosity and erythrocyte deformability were diminished. Improvement of symptoms including vertigo, tinnutus, headache and forgetfulness in the first group was found to be significantly different from the 2nd group at day 30 in a dose dependent manner

Retroperitoneal fibrosis caused by pergolide in a patient with Parkinson's disease

Retroperitoneal fibrosis (RPF) is an uncommon disorder that may cause ureteric obstruction with renal damage. Pergolide, a dopaminergic agonist used in the treatment of Parkinson's disease, has rarely been related to the development of RPF. We report on a 78-year-old woman with Parkinson's disease who presented with hydroureteronephrosis and developed RPF and serosal fibrosis during treatment with pergolide. Following discontinuation of pergolide therapy and placement of a double-J stent, her renal function improved. Inflammatory markers returned to normal limits within two months and the retroperitoneal fibrotic mass became smaller