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Adult idiopathic occlusion of foramen of Monro (AIOFM) is a rare condition that results in hydrocephalus, and bilateral presentation is even rarer. Here we report a case of idiopathic bilateral stenosis of the foramen of Monro in an adult patient and performed a systematic literature review on the current treatment options and outcomes. We performed a systematic review of SCOPUS, Science Direct, and PubMed databases in accordance with PRISMA guidelines. Data on demographics, clinical presentation, imaging findings, type of AIOFM, treatment, and outcomes were collected. A total of 22 cases of bilateral AIOFM were identified in the literature, including ours. The median age was 38.5 years (range: 20–53), with no sex predilection. The most common presenting symptoms were headache (n=16, 73%) and vomiting (n=10, 45%). There were 9 cases of Type 1 AIOFM (stenosis) and 13 cases of Type 2 (membrane occlusion). Majority of patients underwent surgical treatment, mostly endoscopic unilateral foraminoplasty and septostomy (59%), followed by ventriculoperitoneal shunt insertion (31%). One patient underwent medical management only to alleviate her presenting symptoms (seizures). The overall outcome was good for majority of patients at a median follow-up of 6 months. Bilateral AIOFM is a rare condition that may easily be missed, so neurosurgeons should be cognizant of this disease entity. Identification of the type of AIOFM may guide surgical decision-making. Treatment options include neuroendoscopic procedures such as septostomy and foraminoplasty, and ventriculoperitoneal shunt insertion. •AIOFM is a rare condition that may easily be missed, so neurosurgeons should be cognizant of this disease entity.•Adult idiopathic bilateral occlusion of the foramina of Monro into four types [4].•Identifying the type of AIOFM with cranial MRI may guide the neurosurgeon in selecting the best management.•Treatment options include neuroendoscopic procedures such as septostomy and foraminoplasty, and VP shunt insertion.

With the progress of measurement apparatus and the development of automatic sensors, it is not unusual anymore to get large samples of observations taking values in high-dimension spaces, such as functional spaces. In such large samples of high-dimensional data, outlying curves may not be uncommon, and even a few individuals may corrupt simple statistical indicators, such as the mean trajectory. We focus here on the estimation of the geometric median which is a direct generalization of the real median in metric spaces and has nice robustness properties. It is possible to estimate the geometric median, being defined as the minimizer of a simple convex functional that is differentiable everywhere when the distribution has no atom, with online gradient algorithms. Such algorithms are very fast and can deal with large samples. Furthermore, they also can be simply updated when the data arrive sequentially. We state the almost sure consistency and the L 2 rates of convergence of the stochastic gradient estimator as well as the asymptotic normality of its averaged version. We get that the asymptotic distribution of the averaged version of the algorithm is the same as the classic estimators, which are based on the minimization of the empirical loss function. The performances of our averaged sequential estimator, both in terms of computation speed and accuracy of the estimations, are evaluated with a small simulation study. Our approach is also illustrated on a sample of more than 5000 individual television audiences measured every second over a period of 24 hours.

A model for network panel data is discussed, based on the assumption that the observed data are discrete observations of a continuous-time Markov process on the space of all directed graphs on a given node set, in which changes in tie variables are independent conditional on the current graph. The model for tie changes is parametric and designed for applications to social network analysis, where the network dynamics can be interpreted as being generated by choices made by the social actors represented by the nodes of the graph. An algorithm for calculating the Maximum Likelihood estimator is presented, based on data augmentation and stochastic approximation. An application to an evolving friendship network is given and a small simulation study is presented which suggests that for small data sets the Maximum Likelihood estimator is more efficient than the earlier proposed Method of Moments estimator.

In this paper we consider a linear operator equation in a Hilbert space. Using Hoeffding inequalities, an exponential bound to the solution obtained by a stochastic procedure is established and the values of the step ak for which the procedure converges almost completely (a.co) are discussed. An illustrative application was treated to the solution of a Fredholm integral equation of the second kind.

ObjectOne of the critical steps for the success of intraventricular neuroendoscopic procedures is the entry into the third ventricle and passage of the endoscopy system through the foramen of Monro (FM). A diameter larger than that of the instrument used is considered a prerequisite for safely performing the technique, as damage to this structure can lead to alterations in the fornix and vascular structures. When the foramen diameter is narrow and there is no obstruction/stenosis, the role of foraminoplasty in reducing the risk of complications has not been adequately assessed in the literature.MethodsA review of endoscopic procedures conducted at our center since 2018 was undertaken. Cases in which preoperative imaging indicated a FM diameter < 6 mm and foraminoplasty technique was applied were examined to determine the technical and functional success of the procedure. The technical success was determined by completing the neuroendoscopic procedure with the absence of macroscopic lesions in the various structures comprising the foramen and without complications in the follow-up imaging tests. Functional success was defined as the absence of cognitive/memory alterations during the 3-month postoperative follow-up. Additionally, a review of the various forms of foraminoplasty described in the literature is conducted.ResultsIn our cohort, six patients were identified with a preoperative FM diameter < 6 mm without obstruction or stenosis. Foraminoplasty was planned for these cases to facilitate various intraventricular neuroendoscopic procedures. In all instances, the technique was successfully performed without causing macroscopic damage to the structures comprising the foramen. Follow-up visits included various cognitive tests to assess potential sequelae related to microscopic damage to the fornix. None of the patients exhibited anomalies.ConclusionForaminoplasty in patients with a narrow FM without signs of stenosis/obstruction is a useful technique to reduce the risk of complications during the passage of the endoscopy system through this structure, enabling the safe performance of neuroendoscopic procedures.

Background Reaching a tumor within the third ventricle is challenging, and planning an accessible trajectory is crucial without injuring the surrounding structures. Case summary We report a 5-year-old boy presented with headache and a seizure where sequential MRI brain studies in a short time period revealed a rapid growing immature teratoma within the third ventricle with hydrocephalic changes. Several management procedures were performed for CSF diversion and medical treatment of the tumor with chemotherapy and stem cell therapy. The tumor was rapidly growing, and surgical excision was decided. Total resection was achieved via endoscope-assisted microsurgical transcallosal approach. Seven years after surgery, the patient experienced no recurrence of the tumor with a favorable clinical condition. Conclusion We report a rare case of posterior third ventricular immature teratoma where the endoscope-assisted microsurgical technique was implemented with favorable long-term postoperative outcome.

This book is a lively commentary on the eighteenth-century mad-business, its practitioners, its patients (or \"customers\"), and its patrons, viewed through the unique lens of the private case book kept by the most famous mad-doctor in Augustan England, Dr. John Monro (1715-1791). Monro's case book, comprising the doctor's jottings on patients he saw in the course of his private practice--patients drawn from a great variety of social strata--offers an extraordinary window into the subterranean world of the mad-trade in eighteenth-century London. The volume concludes with a complete edition of the case book itself, transcribed in full with editorial annotations by the authors. In the fragmented stories Monro's case book provides, Andrews and Scull find a poignant underworld of human psychological distress, some of it strange and some quite familiar. They place these \"cases\" in a real world where John Monro and othersuccessful doctors were practicing, not to say inventing, the diagnosis and treatment of madness.

Mean-shift is an iterative procedure often used as a nonparametric clustering algorithm that defines clusters based on the modal regions of a density function. The algorithm is conceptually appealing and makes assumptions neither about the shape of the clusters nor about their number. However, with a complexity of O(n 2 ) per iteration, it does not scale well to large datasets. We propose a novel algorithm which performs density-based clustering much quicker than mean shift, yet delivering virtually identical results. This algorithm combines subsampling and a stochastic approximation procedure to achieve a potential complexity of O(n) at each step. Its convergence is established. Its performances are evaluated using simulations and applications to image segmentation, where the algorithm was tens or hundreds of times faster than mean shift, yet causing negligible amounts of clustering errors. The algorithm can be combined with existing approaches to further accelerate clustering.

Background Colloid cysts are rare, benign brain tumors often located in the third ventricle or near the foramen of Monro. They can evoke neuropsychiatric and physical symptoms including migraine, visual changes, memory loss, and sudden loss of consciousness. They are associated with high mortality due to late moderate-to-severe symptom presentation and limited access to neurological and/or neurosurgical expertise. The Colloid Cyst Symptoms Survey (CCSS) was designed and administered anonymously using REDCap and posted to the Colloid Cyst Survivors Facebook group for 6 months in 2022. The CCSS queried about sociodemographic factors, personal history of a colloid cyst, age of cyst diagnosis, neuropsychiatric and physical symptoms/signs before and after surgery, procedure type if their cyst was removed, and follow-up with neurological, neuropsychiatric or psychological services. Psychiatric symptoms within the last two weeks were assessed using the DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult assessing 13 psychiatric domains (American Psychiatric Association). Results Participants included 225 adults who were U.S citizens with a personal history of a colloid cyst. The majority were female (71.3%) and White (94.0%). Age of diagnosis occurred between 12 and 75 years old, median age 42 years. On average, patients reported 2 pre-clinical symptoms leading to diagnosis, most commonly migraine (48.9%) and aura (30.7%). Hydrocephalus was reported by 56.9%. In patients who underwent surgical removal of their colloid cyst, craniotomy (53.9%) was more common than endoscopic removal (42.6%). Common conditions and physical complications persisting after surgery included changes in energy level ( N  = 68), memory problems ( N  = 71), and anxiety ( N  = 46); higher prevalence of post-surgical complications were observed in the hydrocephalus and craniotomy groups. The DSM-5 screener identified areas of concern including memory, anxiety, somatic symptoms, sleep difficulties, anger, depressive symptoms, suicidality, and substance use. Despite this only ~ 1/10 patients received follow-up with psychiatrists or psychologists. Conclusions To our knowledge this is the largest cross-sectional study querying clinical characteristics among colloid cyst survivors. Persisting neuropsychiatric symptoms were reported to be high. People experiencing brain surgery, even for benign tumors, need to be assessed for neuropsychiatric morbidity.

The efficiency of Monte Carlo simulations is significantly improved when implemented with variance reduction methods. Among these methods, we focus on the popular importance sampling technique based on producing a parametric transformation through a shift parameter θ. The optimal choice of θ is approximated using Robbins-Monro procedures, provided that a nonexplosion condition is satisfied. Otherwise, one can use either a constrained Robbins-Monro algorithm (see, e.g., Arouna (Monte Carlo Methods Appl. 10 (2004) 1-24) and Lelong (Statist. Probab. Lett. 78 (2008) 2632-2636)) or a more astute procedure based on an unconstrained approach recently introduced by Lemaire and Pagès in (Ann. Appl. Probab. 20 (2010) 1029-1067). In this article, we develop a new algorithm based on a combination of the statistical Romberg method and the importance sampling technique. The statistical Romberg method introduced by Kebaier in (Ann. Appl. Probab. 15 (2005) 2681-2705) is known for reducing efficiently the complexity compared to the classical Monte Carlo one. In the setting of discritized diffusions, we prove the almost sure convergence of the constrained and unconstrained versions of the Robbins-Monro routine, towards the optimal shift θ* that minimizes the variance associated to the statistical Romberg method. Then, we prove a central limit theorem for the new algorithm that we called adaptive statistical Romberg method. Finally, we illustrate by numerical simulation the efficiency of our method through applications in option pricing for the Heston model.