Enrique C . G . Ventureyra MD,FRCSC,FAANS(L) | University of Ottawa | Université d'Ottawa (original) (raw)

Papers by Enrique C . G . Ventureyra MD,FRCSC,FAANS(L)

European Journal of Paediatric Neurology, 1997

Pediatric Neurosurgery, 1980

Contemporary Neurosurgery, 1997

Neurosurgery, 1997

ABSTRACT We describe the concept of a new syringostomy technique. The technique includes the inse... more ABSTRACT We describe the concept of a new syringostomy technique. The technique includes the insertion of a myringostomy tube through a small myelotomy at the level of maximum enlargement of the syrinx. The inner diameter of the myringostomy tube is 1.14 mm. This technique reduces the potential risks that are associated with other techniques that use bulky silastic catheters that are left inside the spinal cord. We think that this technique is the least invasive of all similar techniques and that, in terms of drainage, the myringostomy tube is as efficient as commonly used silastic catheters.

Canadian Medical Association journal, 1983

A retrospective study was conducted of the 880 children with head injuries consecutively admitted... more A retrospective study was conducted of the 880 children with head injuries consecutively admitted to the Children's Hospital of Eastern Ontario in Ottawa from July 1976 to June 1978. It confirmed a boy:girl ratio of about 2:1, with a peak of 3.5:1 around 7 years of age. The largest number of head injuries was in children under 1 year of age. Injuries were most common in summer and spring, and most were caused by falls. The most common place for head injuries was in the home, but the single most common cause of injuries was bicycle accidents, which were responsible for 12% of all the head injuries. Skull fractures were found in 30% of all the patients. Of the 34 patients with severe head injuries 8 (24%) died, 9 (26%) had a moderate residual disability and 17 (50%) made a good recovery. There were no other deaths, so the mortality for the entire group of 880 patients was 0.9%.

$Research paper thumbnail of Epilepsy surgery for 5- to 18-year old patients with medically refractory epilepsy - is it cost efficient?$

Childs Nervous System, Sep 21, 1999

This study was designed to examine the question of whether cortical resection for children and ad... more This study was designed to examine the question of whether cortical resection for children and adolescents with medically refractory epilepsy was less costly and more effective than the medical alternative. The study design used a decision analysis model. Data on outcome probabilities were based on literature review and local experience. The time span of the study was 25 years. Though the initial costs for the surgically treated group were significantly greater than those for the medical group, the time-cost lines intersected at 14 years after surgery. Surgery remained cheaper thereafter.

Pediatric Neurosurgery, 1979

The case of an 8-year-old boy with spontaneous spinal epidural haematoma and complete post-operat... more The case of an 8-year-old boy with spontaneous spinal epidural haematoma and complete post-operative recovery is described. A review of the literature with particular emphasis on the paediatric age-group is given. The clinical presentation and aetiology are discussed.

Neurosurgery, May 1, 1994

VENTRICULOPERITONEAL SHUNT MALFUNCTION is most commonly caused by obstruction of the ventricular ... more VENTRICULOPERITONEAL SHUNT MALFUNCTION is most commonly caused by obstruction of the ventricular catheter by choroid plexus. Such ventricular catheter obstructions remain a major unsolved problem, despite improvements in materials, catheter design, new valves, and increased emphasis on precise techniques favoring optimal catheter placement. Shunt malfunction demands elective and often urgent open surgical intervention to revise the shunt system. Such revisions require a general anesthetic in addition to the operative procedure and are followed by a minimum hospitalization of 2 to 3 days. Our experience with hundreds of shunt revisions prompted novel ideas for the development of a new ventricular catheter to treat or prevent this common and previously unresolved difficulty effectively.

$Research paper thumbnail of Patient satisfaction with surgical treatment of refractory epilepsy done in childhood and early adolescence$

Childs Nervous System, Mar 4, 1998

Neurosurgery, Dec 1, 1996

Gas-containing brain abscesses are rare, and the vast majority are caused by Clostridium perfring... more Gas-containing brain abscesses are rare, and the vast majority are caused by Clostridium perfringens. Significant simultaneous fungal infection in a bacterial abscess is even rarer. We present such a case and review the literature. A 21-month-old male patient sustained a penetrating head injury in a barnyard, developed a gas-containing left parietal brain abscess, and presented with high fever, galeal swelling, and seizure. The patient initially underwent debridement of his wound and then repeated aspirations. The initial cultures revealed pure growth of Clostridium perfringens. Despite appropriate antibiotic therapy, serial neuroimaging did not demonstrate a decrease in the size of the cavity. An excision had to be undertaken 6 weeks after the injury. The culture from the excised specimen revealed an unexpected growth of a saprophytic and opportunistic fungus, Myceliophthora thermophila. Antifungal treatment consisting of the administration of liposomal amphotericin B and itraconazole was then performed. The child was well and neurologically intact 6 months after the excision. Our review revealed 38 cases of clostridial brain abscess in the literature. Despite the reputation of the organism, the outcome with clostridial brain abscesses was relatively benign. The main characteristics of clostridial brain abscesses are highlighted, with reference to their optimal treatment. Our review also revealed that fungal infection after a penetrating head injury is extremely rare and often fatal. Our case seems to be the first in the medical literature with growth of M. thermophila as a causative agent for intracranial suppuration.

$Research paper thumbnail of Cortical Microdysplasia and Surgical Outcome in Refractory Epilepsy of Childhood$

Pediatric Neurosurgery, 1998

This paper examines the relationship between the degree and type of cortical microdysplasia as re... more This paper examines the relationship between the degree and type of cortical microdysplasia as reported on pathological examination and the degree of seizure control after cortical resection in 70 children with medically refractory epilepsy. Cases selected for this review had to have had medically refractory epilepsy; had their first cortical resection before the age of 18 years, and have sufficient pathological material available for review. The pathological review was done blinded as to results of seizure control outcome postsurgery. Pathological material was classified to type and degree of microdysplasia, according to the classification scheme of Brannstrom. 11% of patients had no evidence of dysplasia; 77% had microdysplasia type 2, and 12% had focal dysplasia (type 3). No significant correlation between degree of seizure control postoperatively and type of microdysplasia was seen in this series.

Childs Nervous System, Jan 30, 2003

Canadian Journal of Neurological Sciences, Jul 1, 2010

Critical Reviews in Neurosurgery, Jun 1, 1998

Partial dorsal root rhizotomy and intrathecal administration of baclofen are two modalities used ... more Partial dorsal root rhizotomy and intrathecal administration of baclofen are two modalities used to treat spasticity in children. Each has its own inclusion criteria and mechanism of action. Both have been proven to relieve spasticity, and both have their particular side effects and complications. Programmable pumps for the accurate and reliable administration of intrathecal baclofen are expensive and demand a lifelong commitment to medication refill and hardware reimplantation. Partial dorsal root rhizotomy is a one-time surgical procedure, which differs from one center to another. It requires a team approach for patient selection and to determine whether other treatment options should take precedence. It also requires a period of postoperative reeducation in the form of physiotherapy. While some centers use intraoperative nerve root stimulation and muscle response recording as a guidance tool for rootlet sectioning, others claim equally good results without the added timeconsuming technology.

Childs Nervous System, Feb 18, 2003

Psychosocial functioning was examined in 13 children who had undergone surgical treatment for int... more Psychosocial functioning was examined in 13 children who had undergone surgical treatment for intractable epilepsy. The ratings of each child's social, emotional and behavioural problems were obtained via parent and teacher reports made an average of 2 years post-operatively. Results: Parents viewed their children as having greater social difficulties than reported in standardisation samples. Although the overall level of difficulty fell below clinically significant cutoffs , the proportion of children who were rated as having clinically significant levels of difficulties approached significance. Teachers rated these children as displaying more symptoms of anxiety and depression, although the levels remained subclinical. Discussion: These results are discussed in view of the complex interaction between neurological and environmental variables involved in social-emotional functioning following surgical treatment for epilepsy.

Surgical Neurology, 1981

Data are presented for the first 50 patients with cerebral palsy who underwent chronic cerebellar... more Data are presented for the first 50 patients with cerebral palsy who underwent chronic cerebellar stimulation for symptom alleviation. We observed significant shorter and longer term improvement in spasticity as well as athetosis, speech, and functional status. Continuing increments in ...

Journal of Neurosurgery, Dec 1, 1996

ALFUNCTION of ventriculoperitoneal (VP) shunts occurs most often because of proximal end obstruct... more ALFUNCTION of ventriculoperitoneal (VP) shunts occurs most often because of proximal end obstruction. However, distal end malfunction due to outgrown, fractured, disconnected, or occluded peritoneal catheters may account for up to 30% of VP shunt failures. We describe a simple technique that uses the existing fibrous tract around the distal tubing as the "shunt passer" into the abdomen, thereby avoiding minilaparotomy.

Journal of Pediatric Neurosciences, 2006

ABSTRACT Spinal injuries in the pediatric population are relatively rare. Hence there is not enou... more ABSTRACT Spinal injuries in the pediatric population are relatively rare. Hence there is not enough knowledge, experience and exposure amongst pediatric neurosurgeons about spinal injuries in children. They have to rely on general spinal or pediatric orthopedic colleagues for a comprehensive management of spine and spinal cord trauma. In addition, the advances in spinal instrumentation techniques and vast array of implantable devices for spinal stabilization add to the complexity of the problem. It is imperative that a pediatric neurosurgeon should be aware of the mechanics of spinal injury and recent advances in the management strategy of pediatric spinal injuries.

$Research paper thumbnail of The preoperative assessment in the planning of surgical management of medically refractory epilepsy in the pediatric patient$

Childs Nervous System, Dec 4, 2000

Surgical intervention in refractory epilepsy in children offers the hope of seizure control. For ... more Surgical intervention in refractory epilepsy in children offers the hope of seizure control. For the patient, the preoperative assessment is a major factor in whether he or she is selected as a patient who will potentially benefit. It also plays an important part in the choice of the surgical intervention to be used. This paper reviews the investigations available and suggests an investigational algorithm for use in the pediatric population.