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Table of Contents    
CORRESPONDENCE
Year : 2011  |  Volume : 59  |  Issue : 2  |  Page : 323

Authors' reply


1 Department of Neurosurgery, University of Debrecen, Medical and Health Sciences Center, Debrecen, Hungary
2 Department of Pediatrics, University of Debrecen, Medical and Health Sciences Center, Debrecen, Hungary
3 Department of Biomedical Laboratory, and Imaging Science, University of Debrecen, Medical and Health Sciences Center, Debrecen, Hungary

Date of Submission12-Jan-2011
Date of Decision13-Jan-2011
Date of Acceptance20-Jan-2011
Date of Web Publication7-Apr-2011

Correspondence Address:
L Novak
Department of Neurosurgery, University of Debrecen, Medical and Health Sciences Center, Debrecen
Hungary
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Novak L, Pataki I, Nagy A, Berenyi E. Authors' reply. Neurol India 2011;59:323

How to cite this URL:
Novak L, Pataki I, Nagy A, Berenyi E. Authors' reply. Neurol India [serial online] 2011 [cited 2019 Aug 25];59:323. Available from: http://www.neurologyindia.com/text.asp?2011/59/2/323/79162


Sir,

Thank you for the opportunity to respond to reflections of Udayakumaran [1] and colleagues. We agree that the cases reported by them [2],[3] are very similar to ours. The authors eloquently postulated that the chronic transtentorial herniation was a sequel of overdrainage in the first patient [2] and developmental in the second one. [3] We totally agree with the contents of the letter. Our child underwent numerous shunt-related operations. He had only shunt obstructions, and in each period of malfunction several interventions have been implemented to restore the cerebrospinal fluid (CSF) circulation. Whenever the posterior fossa shunt was revised, the supratentorial was also revised within 1 or 2 days and similarly the revisions in the reverse order. We ruled out CSF overdrainage when the child was asymptomatic. We feel that our patients might have developed pressure gradient during one of the episodes of supratentorial obstruction, which was responsible for herniation. It is quite possible that during our search of the literature we had missed to hit the articles by Udayakumaran and colleagues. There is no dispute that the overdrainage theory can explain the phenomena of chronic uncal herniation. The proposed treatment algorithm thus implicates the possible obviation of posterior fossa shunts in premature babies. [4]

 
 » References Top

1.Udayakumaran S. Bilateral transtentorial herniation and isolated fourth ventricle: A scientific note. Neurol India 2011;59:322-3.  Back to cited text no. 1
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2.Udayakumaran S, Ben Sira L, Constantini S. Chronic uncal herniation secondary to posterior fossa shunting: Case report and literature review. Childs Nerv Syst 2010;26:267-71.  Back to cited text no. 2
[PUBMED]  [FULLTEXT]  
3.Udayakumaran S, Ben Sira L, Constantini S. Temporal lobe herniation of developmental origin: A novel radiological association with open spina bifida and Chiari II malformation. Childs Nerv Syst 2010;26:277-8.  Back to cited text no. 3
    
4.Udayakumaran S, Biyani N, Rosenbaum DP, Ben-Sira L, Constantini S, Beni-Adani L. Posterior fossa craniotomy for trapped fourth ventricle in shunt-treated hydrocephalic children: Long-term outcome. Clinical article. J Neurosurg Pediatr 2011;7:52-63.  Back to cited text no. 4
[PUBMED]  [FULLTEXT]  



This article has been cited by
1 Authorsę reply
Tripathi, M. and Tripathi, M. and Vibha, D. and Gowda, N. and Bal, C. and Malhotra, A.
Neurology India. 2011; 59(2): 324
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