We have located links that may give you full text access.
CASE REPORTS
JOURNAL ARTICLE
Severe intracranial hypertension in slit ventricle syndrome managed using a cisterna magna-ventricle-peritoneum shunt.
Journal of Neurosurgery 2006 April
OBJECT: Severely increased intracranial pressure (ICP) can be life threatening in patients who had previously undergone shunt treatment but who do not experience ventricular enlargement. The authors analyzed the utility of placing shunts into the cisterna magna concurrently with ventricular shunts in patients who were not candidates for lumboperitoneal (LP) shunt placement.
METHODS: Ten patients treated with cisterna magna-ventricle-peritoneum (CMVP) shunts for complex problems of shunt function were reviewed retrospectively. All patients had documented increases in ICP and ventricles that did not expand despite life-threatening increases (> 80 mm Hg in one case) in ICP. Between 1995 and 2003, 10 patients (four males and six females, age range 4-32 years) were identified as having life-threatening increases in ICP despite small or slit-like ventricles on imaging studies. Each episode was documented with intraparenchymal pressure monitoring. All patients had documented ventricular catheter failures at the time of the intervention, and all had undergone at least one previous attempt to treat the condition with a valve upgrade and replacement of the ventricular catheter. Three patients had achondroplasia, four had spina bifida, and three had a preexisting Chiari malformation Type I. All patients improved after the procedure, and none suffered permanent complications. For at least 48 hours after surgery, all patients underwent intraparenchymal monitoring of ICP (an intraparenchymal monitor was used that documented normal ICP).
CONCLUSIONS: The CMVP shunts are an excellent option for patients who are not candidates for LP shunts but who have high ICP and ventricles that do not enlarge at shunt failure. The ability to access the spinal fluid in the cortical subarachnoid space presumably accounts for this success.
METHODS: Ten patients treated with cisterna magna-ventricle-peritoneum (CMVP) shunts for complex problems of shunt function were reviewed retrospectively. All patients had documented increases in ICP and ventricles that did not expand despite life-threatening increases (> 80 mm Hg in one case) in ICP. Between 1995 and 2003, 10 patients (four males and six females, age range 4-32 years) were identified as having life-threatening increases in ICP despite small or slit-like ventricles on imaging studies. Each episode was documented with intraparenchymal pressure monitoring. All patients had documented ventricular catheter failures at the time of the intervention, and all had undergone at least one previous attempt to treat the condition with a valve upgrade and replacement of the ventricular catheter. Three patients had achondroplasia, four had spina bifida, and three had a preexisting Chiari malformation Type I. All patients improved after the procedure, and none suffered permanent complications. For at least 48 hours after surgery, all patients underwent intraparenchymal monitoring of ICP (an intraparenchymal monitor was used that documented normal ICP).
CONCLUSIONS: The CMVP shunts are an excellent option for patients who are not candidates for LP shunts but who have high ICP and ventricles that do not enlarge at shunt failure. The ability to access the spinal fluid in the cortical subarachnoid space presumably accounts for this success.
Full text links
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app