Harold Rekate

Harold Rekate
Hofstra University · Department of Neurosurgery

MD

About

100
Publications
16,746
Reads
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1,682
Citations
Additional affiliations
December 2019 - December 2020
Hofstra Northwell School of Medicine
Position
  • Professor
Description
  • I am Professor Emeritis of Neurosurgery. I have continued my research efforts in Intracranial pressure and hydrocephalus with four recent peer reviewed papers on the subjects. I continue with teaching and taught the Hofstra medical students about neuroanatomy in January of 2020.
Education
September 1962 - June 1966
Duike University
Field of study
  • Chemistry

Publications

Publications (100)
Article
Full-text available
Object The purpose of this work is to review the pathogenesis and pathophysiology of hydrocephalus in patients with achondroplasia as a guide to its management throughout life. Methods A review of the literature related to neurosurgical issues in achondroplasia with specific focus on cerebrospinal fluid physics, clinical management, and outcome of...
Article
Full-text available
The aquaporin (AQP) family of water channels are a group of small, membrane-spanning proteins that are vital for the rapid transport of water across the plasma membrane. These proteins are widely expressed, from tissues such as the renal epithelium and erythrocytes to the various cells of the central nervous system. This review will elucidate the b...
Article
OBJECTIVE The incidence of posttraumatic ventriculomegaly (PTV) and shunt-dependent hydrocephalus after nonaccidental head trauma (NAHT) is unknown. In the present study, the authors assessed the timing of PTV development, the relationship between PTV and decompressive craniectomy (DC), and whether PTV necessitated placement of a permanent shunt. A...
Chapter
Imaging of hydrocephalus in utero, in infants and children is critically dependent on an understanding of the pathophysiology and treatment options for this condition in this age spectrum. For this reason, this chapter deals not only with the imaging modalities used to study hydrocephalus and how they are applied but also reviews key aspects of the...
Article
Full-text available
After two years of study and conversation a group of 20 hydrocephalus investigators developed a consensus on a new classification of hydrocephalus based on point of obstruction. This new classification has proved useful in the diagnosis and treatment of patients with hydrocephalus of all types and is especially helpful in assessing the various trea...
Article
Children who sustained non-accidental head trauma (NAHT) are at severe risk for mortality within the first 24 hours after presentation. Extent of delay in seeking medical attention may be related to patient outcome. A ten year, single-institution, retrospective review of 48 cases treated at a large tertiary Children's Hospital reported to the New Y...
Article
A 25-year-old man with Crouzon syndrome complicated by pseudotumor cerebri and multiple shunt failures presented with progressive back and neck pain, intermittent headaches, and associated vomiting secondary to shunt infection. Due to his previous history of repeated failure of both ventriculoperitoneal and lumboperitoneal (LP) shunting procedures,...
Article
In the recent paper by Farahmand et al 1 a new fully implantable telemetered intracranial pressure monitoring device (Raumedic AG, Helmbrecht, Germany) is used to study changes in intracranial pressure that occur in various positions and with various valve settings. The patient population studied here included 15 adult patients with ‘communicating...
Chapter
Hypothalamic hamartomas (HH) are rare non-neoplastic congenital malformations arising from the inferior hypothalamus and associated with gelastic seizures, precocious puberty, and cognitive problems. Except patients with precocious puberty, all others will require surgical treatment. They are classified anatomically according to the Delalande class...
Article
Full-text available
Hypothalamic hamartomas (HHs) are benign lesions that are often associated with central precocious puberty and may present with gelastic seizures. Treatment modalities for HH include medical therapy with long-term gonadotropin-releasing hormone analogs or resection. The authors report the case of a 7-year-old girl who was diagnosed with an HH due t...
Article
Full-text available
The outcome of pediatric hydrocephalus, including surgical complications, neurological sequelae and academic achievement, has been the matter of many studies. However, much uncertainty remains, regarding the very long-term and social outcome, and the determinants of complications and clinical outcome. In this paper, we review the different facets o...
Article
This study aimed at identifying outcomes with respect to seizures, morbidity, and mortality in adult patients undergoing resective or Gamma Knife surgery (GKS) to treat intractable epilepsy associated with hypothalamic hamartoma (HH). Adult patients undergoing surgical treatment for HH-related epilepsy were prospectively monitored at a single cente...
Article
Full-text available
Between 2009 and 2011 an attempt has been made to develop a consensus on the classification of hydrocephalus. Clinicians and basic scientists who are recognized internationally for their work in hydrocephalus attended working meetings in which the concepts of classification of hydrocephalus were discussed at length. This review attempts to explain...
Article
Aim To report a successful treatment of an atypical case of pseudotumor cerebri. Background Pseudotumor cerebri is a disorder of raised intracranial pressure. Multiple Case Series have been published about its treatment with sinus stenting. All these cases have had typical presentations. Case An atypical fulminant case of pseudotumor cerebri which...
Article
Hypothalamic hamartomas (HHs) are a malformation of the ventral hypothalamus and tuber cinereum, associated with gelastic seizures and epilepsy. We sought to determine the spectrum of electroencephalography (EEG) abnormalities in a large cohort of HH patients. Data was collected for HH patients undergoing evaluation between 2003 and 2007. Data incl...
Article
The February 2011 issue of Neurosurgical Focus is devoted to a discussion of the recent explosion of information regarding the management of a rather rare birth defect that can have devastating effects on children and adults. The actual prevalence of hypothalamic hamartoma (HH) cannot yet be estimated because the clinical presentation of patients i...
Article
Surgical biopsy of isolated infundibular lesions is indicated in patients who are symptomatic or whose imaging suggests a treatable lesion. Early therapy can prevent irreversible neurological or endocrinological damage and, potentially, metastasis. These considerations justify the small risk associated with surgery. A 5-year-old boy presented with...
Article
Adults treated in infancy for conditions such as spina bifida and hydrocephalus are not cured of their conditions even after reaching adulthood. However, patients who have received coordinated care within a children's facility are unlikely to find the same type of coordinated care when they become adults. This article explores the various causes of...
Article
This review focuses on the problems related to defining hydrocephalus and on the development of a consensus on the classification of this common problem. Such a consensus is needed so that diverse research efforts and plans of treatment can be understood in the same context. The literature was searched to determine the definition of hydrocephalus a...
Article
The cellular mechanisms underlying intrinsic epileptogenesis in human hypothalamic hamartoma (HH) are unknown. We previously reported that HH tissue is composed predominantly of GABAergic neurons, but how GABAergic-neuron-rich HH tissue is intrinsically epileptogenic is unclear. Here, we tested the hypotheses that some HH neurons exhibit immature f...
Article
Drs. Durham and Shipman have provided a thorough study of the process of training pediatric neurosurgeons through a year-long fellowship following the completion of a neurosurgical residency and the procedure of obtaining certification from the American Board of Pediatric Neurological Surgery (ABPNS). From the data presented the authors predicted t...
Article
We present an overview of the history, development, technological advancements, current application, and future trends of cranial endoscopy. Neuroendoscopy provides a safe and effective management modality for the treatment of a variety of intracranial disorders, either tumoral or non-tumoral, congenital, developmental, and degenerative, and its kn...
Chapter
Full-text available
Hydrocephalus in the context of spina bifida may represent the most complicated and confusing form of congenital hydrocephalus. Essentially all patients with spina bifida aperta have an associated Chiari II malformation. In some, especially those with very low lesion levels, this malformation may be very mild. Experimental evidence suggests that th...
Article
Full-text available
Abstract The aim of this review is to refine the definition and classification of hydrocephalus as a preview to developing an international consensus on the nomenclature of this complex condition. This proposed definition and classification is based on my own work in this area and is intended to promote a debate on the concepts presented. A liter...
Article
Full-text available
Abnormalities in GABA(A) receptor structure and/or function have been associated with various forms of epilepsy in both humans and animals. Whether this is true for patients with gelastic seizures and hypothalamic hamartoma (HH) is unknown. In this study, we characterized the pharmacological properties and native subunit composition of GABA(A) rece...
Article
The hypothalamic hamartoma (HH) is a rare developmental malformation commonly associated with gelastic seizures that are notoriously refractory to medical therapy. Recent evidence supports the intrinsic seizure propensity of HH. Despite increasing clinical recognition of this condition, the mechanisms of seizure genesis in HH tissue remain unclear....
Article
Objective To determine if an etiological difference exists between isolation of the lateral ventricle and isolation of the fourth ventricle after ventricular shunting.Methods Cases of symptomatic isolation of the lateral and fourth ventricles were reviewed retrospectively. The ages at presentation of ventricular isolation, the time course to develo...
Article
Object. The goal of this investigation was to establish whether pressure gradients exist between the ventricles, brain tissue, and subarachnoid space when acute or chronic hydrocephalus develops. Such gradients are hypothesized by many models of hydrocephalus, but considerable controversy continues about their existence. Methods. A stereotactic fra...
Article
The hypothalamic hamartoma (HH) is a rare developmental malformation often characterized by gelastic seizures, which are usually refractory to medical therapy. The mechanisms of epileptogenesis operative in this subcortical lesion are unknown. In this study, we used standard patch-clamp electrophysiological techniques combined with histochemical ap...
Article
ETV using contemporary instrumentation has been used for more than 50 years, but its use has become widespread only in the last 10 to 15 years. Randomized prospective trials comparing ETV with shunts are needed before definitive statements can be made about the role of the former in managing the many forms of hydrocephalus. The absolute and relativ...
Article
This review considers the production and absorption of cerebrospinal fluid (CSF) as they relate to intracranial pressure (ICP) in normal individuals and patients with hydrocephalus. It also considers the physics of various types of shunts used to treat hydrocephalus. The hope is that understanding normal and abnormal CSF flow and the physics of shu...
Article
Over the past 15 years, I have had the privilege of participating in the development of an organizational focus for a variety of organizations, including the American Society of Pediatric Neurosurgeons (ASPN). In only one of them have I actually been part of the creation of the organization. In the others, however, I have been present at a time of...
Article
Full-text available
Shunt systems with differential pressure valves are prone to the complications of overdrainage. A programmable valve permits adjustment of the opening pressure of the valve. In this paper the authors report the incidence of subdural fluid collections in a randomized trial of programmable compared with conventional valves, and they describe methodol...
Article
Tadanori Tomita: This is a 3.5-year-old Caucasian female from the Island of Crete in Greece. She had been normal until 2 months prior to admission, when she started to have increasing headaches, instability and dizziness involving ataxia. She also started to have a head tilt. The patient was noted to have an ocular anomaly by a local ophthalmologis...
Article
Introduction: Infection with mucormycosis produces a fulminant and commonly fatal course. Rhinocerebral infection is the most common cranial form. Procedures: Two Siberian huskies mauled a 3-year-old girl who developed invasive mucormycosis of the scalp, skull, and jaw. She manifested acute respiratory distress syndrome and was maintained using ext...
Article
As part of a series of essays about the first 25 years of the International Society for Pediatric Neurosurgery – what we have accomplished and where we have been – I have decided to turn my attention to where we are now and where we are going. A corollary to consider, perhaps, is where we should be going. In other words, what is the appropriate rel...
Article
Information. The aim of the author was to test the viability of the allogeneic bone paste method as a means of intrauterine surgical restoration of the bone deficit in spina bifida. In this study, eight macaque monkeys (Macaca mulatta) were used. The lumbosacral region was exposed by uterotomy in eight monkey fetuses on day 110‐125 of the 160- to 1...
Article
Eight infants with choroid plexus carcinomas were treated with surgery, prolonged postoperative chemotherapy and delayed radiation. The results suggest that some infants with choroid plexus carcinomas can be successfully treated with multimodality therapy, even allowing children with less than a gross total resection to have prolonged disease-free...
Article
Patients born with craniofacial syndromes such as Crouzon’s syndrome will often develop hydrocephalus after their initial craniofacial reconstructive procedures. We have treated 10 patients with Crouzon’s syndrome; 5 patients required a shunting procedure after cranial remodeling. Each of these 5 shunted patients later demonstrated chronic tonsilla...
Chapter
A cavernous malformation or cavernous angioma is one of the four types of vascular malformations of the central nervous system. These lesions have been considered rare in the clinical setting, although they are not uncommon findings at autopsy.1–3 The availability of magnetic resonance (MR) imaging has increased the number of cavernous malformation...
Article
: Although mycotic aneurysms tend to occur with greater frequency in children than adults, few cases of intracranial infectious aneurysms have been reported in children less than 1 year of age. The case of a previously healthy 7-month-old patient who suffered intracerebral and subarachnoid hemorrhage from multiple aneurysms of the middle cerebral a...
Article
: The cases of 13 infants (median age, 3 months) who sustained nonaccidental trauma were reviewed. All presented with profound neurological impairment, seizures, retinal hemorrhages, and intracranial subarachnoid and/or subdural hemorrhages. Of 8 infants who died, autopsy was performed on 6. No patient had a skull fracture, and only one had an extr...
Article
Intracarotid chemotherapy has been suggested as an additional mode of therapy in patients with brain tumors. Seven comatose patients received intracarotid 5-fluorouracil and adriamycin after intracarotid infusion of 25% mannitol to open the blood-brain barrier at the tumor site. Five of seven patients became fully functional for 3-12 months. Anothe...
Article
A child who developed generalized bleeding immediately after placement of a ventriculoperitoneal shunt was found to have evidence of disseminated intravascular coagulation (DIC). Infusion of fresh frozen plasma was followed promptly by improvement in laboratory values and cessation of bleeding. Complications of the acute bleeding episode included i...
Article
A case history illustrating the potential clinical significance of subependymoma is presented. Fine structural studies indicate that the tumor is composed of cells having the cytoplasmic features of ependyma, astrocytes, and transitional cells. Its composition and structure are alike those in the adult mammalian subependymal layer.

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