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VP shunt complications in hydrocephalus

Sirachai Piyachon, Nunthasiri Wittayanakorn, Lisa Kittisangvara, Paveen Tadadontip
OBJECTIVE: To evaluate the role of endoscopic cyst fenestration and endoscopic guided VP shunt insertion in multi-loculated hydrocephalus in children. METHOD: A retrospective analysis was performed on 20 patients with multi-loculated hydrocephalus who underwent endoscopic cyst fenestration (ECF) alone or in combination with VP shunt revision or insertion between August 2014 and December 2016 with the extended follow-up period to December 2017. RESULTS: Thirty-one ECFs were performed: ECF alone, 10 operations in 8 cases, and 21 ECFs with shunt insertion in 12 cases...
January 12, 2019: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
M Dobran, D Nasi, F Mancini, M Gladi, P Ruscelli, M Scerrati
BACKGROUND: Ventriculoperitoneal (VP) shunt is the most common neurosurgical procedure to treat obstructive and communicating hydrocephalus in children and adults but failure are frequent. The knowledge of risk factors related to abdominal shunt failure is useful to avoid complications. PATIENTS AND METHODS: We analyze retrospectively 86 adults patients affected by obstructive and communicating hydrocephalus operated for VP shunt at our Institution. Statistical analysis was performed in order to correlate shunt malfunctioning with type of abdominal approach (trocar vs mini-laparotomy), perioperative infective status, sex, bowel distention and length of surgical time...
November 2018: Il Giornale di Chirurgia
Rohen Harrichandparsad, Syed Sameer Nadvi, Mahomed-Yunus Suleman Moosa, James Rikus van Dellen
BACKGROUND: In 2000, we advised against insertion of a ventriculoperitoneal shunt (VPS) in human immunodeficiency virus (HIV)-positive patients with tuberculous meningitis (TBM) complicated by hydrocephalus. However, this was in the era when combination antiretroviral therapy (ART) was not freely available in South Africa. In this subsequent preliminary report, we describe the outcome of ventriculoperitoneal shunting in patients with TBM and hydrocephalus who are HIV positive and receiving ART...
December 7, 2018: World Neurosurgery
Cheng-Hsin Cheng, Hung-Lin Lin, Hao-Yu Chuang
Tonsillar herniation is a rare and seldom reported complication after lumboperitoneal (LP) shunting. There have been only few reports that have presented possible options for treatment with varying degrees of success. In this report, we describe a rare case of tonsillar herniation after LP shunting and review related literature. A 17-year-old girl with hydrocephalus related to a traumatic brain injury underwent implantation of an adjustable pressure shunt (valve setting2.5) and a small lumen peritoneal catheter via the L4-L5 interspinal space...
December 6, 2018: British Journal of Neurosurgery
Amr Ali Hasanain, Ahmed Abdullah, Mohamed F M Alsawy, Mohamed A R Soliman, Ammar Ali Ghaleb, Reem Elwy, Ahmed A M Ezzat, Ahmed Al Menabbawy, Ahmed A Marei, Bassante Abd El Razik, Mostafa I El Hamaky, Henry W S Schroeder, Steffen Fleck, Ahmed El Damaty, Sascha Marx, Stephan Nowak, Jörg Baldauf, Ahmed Zohdi, Ehab Ahmed El Refaee
OBJECTIVES:  Ventriculoperitoneal (VP) shunting is commonly used to treat pediatric hydrocephalus, but failure rates are high. VP shunt failure in children is mostly caused by infection and/or proximal/distal shunt obstruction. However, to our knowledge, no previous reviews have discussed this topic using only clinical studies when age-related data could be obtained. This systematic review aimed at reevaluating what is already known as the most common causes of shunt failure and to determine the incidence and causes of VP shunt failure during the first 2 years of life as a step to establish solid evidence-based guidelines to avoid VP shunt failure in infants...
December 3, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Guru Dutta Satyarthee, Sanjeev Lalwani
Calcification is uncommon in chronic subdural hematoma and popularly known as calcified chronic subdural hematoma (CSSDH), and about hundred cases are reported in the form of isolated cases report. The calcified inner membrane of chronic subdural hematoma gets adherent to underlying cerebral cortex preventing re-expansion of the brain and producing mass effect. Calcification can develop in chronic subdural hematoma of traumatic origin or postmeningitic effusion or extremely rarely after shunt surgery. CCSDH is also known as armored brain or Matrioska head and those related to cerebrospinal fluid diversion ventriculoperitoneal (VP) shunt surgery, constitute one of the rare complications of shunt, and development is attributed to overdrainage of shunt...
October 2018: Asian Journal of Neurosurgery
Andrew Aranha, Ajay Choudhary, S Bhaskar, L N Gupta
Objectives: The objective of this study was to compare safety and efficacy of endoscopic third ventriculostomy (ETV) versus ventriculoperitoneal (VP) shunt in the treatment of hydrocephalus in tuberculous meningitis (TBM) and to assess clinical and radiological profiles of patients with TBM that would be better suited to either VP shunt or ETV. Methods: This study was a single-center randomized prospective study on 52 patients with TBM hydrocephalus in the pediatric age group (<18 years of age)...
October 2018: Asian Journal of Neurosurgery
O Krejčí, T Krejčí, R Lipina
Posttraumatic hydrocephalus (PH) is a common complication of craniocerebral trauma. It is necessary to bear this entity in mind, especially when managing craniocerebral trauma patients, because if not detected in time, it can significantly affect morbidity and mortality. It needs to be distinguished from brain atrophy with axonal degeneration, a condition requiring an entirely different treatment approach. Key words: hydrocephalus - posttraumatic - VP shunt - brain CT - progression of neurological status.
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Se Youn Jang, Choong Hyun Kim, Jin Hwan Cheong, Jae Min Kim
Objective: Placement of a ventriculoperitoneal (VP) shunt is a common neurosurgical procedure for cerebrospinal fluid diversion. A rare complication is delayed intracranial hemorrhage (ICH) secondary to VP shunting, and only a few patients with this complication have been reported. We investigate the incidence and risk factors of delayed ICH development following VP shunt placement. Methods: Over an 11-year period, 167 patients received a VP shunt for hydrocephalus, and of these, 138 patients were eligible for this study...
October 2018: Korean Journal of Neurotrauma
Mohammad Mousbah Al-Tabbaa, Hani Habal
Meningoencephalitis is a rare complication of relapsing polychondritis. We report a case of a 25-year-old male who presented with visual hallucinations and symptoms of depression and anxiety, white matter changes on MRI, and CSF lymphocytosis, along with inflammatory chondritis seen in his auricle cartilage biopsy. Eventually he was given the diagnosis of RP presenting with meningoencephalitis based on CSF analysis, brain MRI findings, negative serologies, and neurologic exam findings. The patient's clinical state did not improve despite being on IV methylprednisolone for a period of 7 days; afterwards he was switched to oral prednisone with no clinical improvement...
2018: Case Reports in Neurological Medicine
Romy Scholz, Johannes Lemcke, Ullrich Meier, Dirk Stengel
BACKGROUND: Idiopathic normal-pressure hydrocephalus (iNPH) is a distinct form of dementia, characterized by gait ataxia, cognitive impairment and urinary incontinence. In contrast to all other causes of dementia (e.g., Alzheimer-type and others), ventriculoperitoneal (VP) shunt surgery may offer a curative treatment option to patients. While being a rather low-risk type of surgery, it may cause significant over- or underdrainage complications (e.g., headaches, dizziness, vomiting, intracerebral bleeding, etc...
October 17, 2018: Trials
Ashish Chugh, Sarang Gotecha, Gaurav Amle, Anil Patil, Prashant Punia, Megha Kotecha
Background: Ventriculoperitoneal (VP) shunt is commonly used in the treatment of hydrocephalus. Migration and extrusion of the distal end of the VP shunt are relatively rarely occurring complications. Aim: To retrospectively analyze patients with extrusion of the abdominal end of ventriculoperitoneal shunts and evaluate the possible etiology and outcome. Settings and Design: All patients presenting with extrusion of lower end of the shunt were included...
July 2018: Journal of Pediatric Neurosciences
Abigail J Rao, Zoe Teton, Victor Rodriguez, Brandon H Tieu, Ahmed M Raslan
BACKGROUND: Myelomeningocele patients with shunt-dependent hydrocephalus often require multiple shunt revisions, eventually exhausting first-line distal diversion sites. Ventriculoatrial (VA) shunts are used less commonly than ventriculoperitoneal (VP) shunts, but knowledge of their use and complications is important to the neurosurgeon's armamentarium. VA shunts differ from VP and ventriculopleural shunts in that the ideal distal catheter target is an anatomically small area in comparison to the peritoneal and pleural cavities...
September 25, 2018: World Neurosurgery
Neena I Marupudi, Carolyn Harris, Tanya Pavri, Brenna Mell, Rasanjeet Singh, Steven D Ham, Sandeep Sood
OBJECTIVE: Lumboperitoneal (LP) shunts have a role not only in pseudotumor cerebri, but also in patients with slit-like ventricles who are treated with CSF shunting on a chronic basis. Hesitation to utilize LP shunts is based on previous conventional beliefs including the tendency for overdrainage, difficulties accessing the shunt to tap or revise, and risk of progressive cerebellar tonsillar herniation. The authors hypothesized that the use of horizontal-vertical (HV) valves may reduce the risk of these complications, particularly overdrainage and development of Chiari malformation...
September 21, 2018: Journal of Neurosurgery. Pediatrics
Alberto Feletti, Domenico d'Avella, Carsten Wikkelsø, Petra Klinge, Per Hellström
BACKGROUND: Ventriculoperitoneal shunt (VP-shunt) is the standard of treatment for idiopathic normal pressure hydrocephalus (iNPH). However, a thorough investigation of VP-shunt complications in this population is lacking. OBJECTIVE: To present the analysis and the rates of complications progressively occurring during the first year after shunt surgery in the patients with iNPH included in the European multicenter (EU-iNPH) study. METHODS: Patients (n = 142) were prospectively included in the EU-iNPH study by 13 institutions...
August 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
Gregory Czajka, Halley Kreminski
Hydrocephalus can be the result of an infection, obstruction, impaired reabsorption of cerebrospinal fluid (CSF), or an abnormal increase in CSF. Ventriculoperitoneal (VP) shunting is the gold standard treatment for hydrocephalus despite its high rate of complications, including catheter obstruction and infection. Spontaneous cecal perforation by a VP shunt is extremely rare. Headache or subtle change in personality may indicate a VP shunt infection. Early recognition of the infection is critical for optimal patient outcomes...
September 2018: JAAPA: Official Journal of the American Academy of Physician Assistants
Pradyumna Pan
Aim: To study the clinical outcome of shunt surgeries in children with hydrocephalus and evaluate the risk factors for ventriculoperitoneal (VP) shunt failure. Materials and Methods: Patients who underwent VP shunt surgery for hydrocephalus were included. Medical charts, operative reports, imaging studies, and clinical follow-up evaluations were reviewed and analyzed retrospectively. Results: A total of 137 patients with the average age of 20...
April 2018: Journal of Pediatric Neurosciences
Muhammad Junaid, Mamoon Ahmed, Mamoon Ur Rashid
Objective: This study was conducted to assess outcomes in patients with hydrocephalus who underwent ventriculoperitoneal shunting at Keen's point. Methods: This retrospective study was conducted in Combined Military Hospital (CMH) Peshawar. Time frame was four years from January 2011 to January 2015. The presenting complaints, clinical findings, investigations, treatment plans and surgical outcomes were noted. Ventriculo-Peritoneal (VP) shunting was done at Keen's point...
May 2018: Pakistan Journal of Medical Sciences Quarterly
Ahmed A M Ezzat, Mohamed A R Soliman, Amr A Hasanain, Mohamed A Thabit, Hesham Elshitany, Haitham Kandel, Sameh H Abdel-Bari, Ahmed M F Ghoul, Ahmed Abdullah, Mohamed F M Alsawy, Ammar A Ghaleb, Ahmed Al Menabbawy, Ahmed A Marei, Bassante Abd El Razik, Henry W S Schroeder, Sascha Marx, Ahmed Zohdi, Ehab El Refaee
BACKGROUND: Ventriculoperitoneal (VP) shunting is the most commonly performed procedure in the treatment of hydrocephalus. VP shunt migration can occur at different sites. The aim of the study was to present different sites of abnormal distal shunt location, pathophysiology, and the management in each situation. METHODS: Between 2014 and 2017, all patients with hydrocephalus in the Department of Neurosurgery, Cairo University, were gathered prospectively. All pediatric patients below the age of 12 years with shunt migration of the distal end of the VP shunt were identified...
November 2018: World Neurosurgery
Aodhnait S Fahy, Stephanie Tung, Maria Lamberti-Pasculli, James Drake, Abhaya V Kulkarni, Justin T Gerstle
INTRODUCTION: Ventriculoperitoneal shunts (VPSs) are the mainstay of treatment of hydrocephalus but have frequent complications including shunt failure and infection. There has been no comparison of laparoscopic versus open primary VPS insertion in children. We hypothesized that laparoscopic VP shunt insertion may improve patient outcomes. METHODS: A prospectively-maintained, externally-validated database of pediatric patients who underwent VPS insertion at a single center between 2012 and 2016 was reviewed...
July 6, 2018: Journal of Pediatric Surgery
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