Indications for shunt insertion or III ventriculostomy in hydrocephalic children, guided by lumbar and intraventricular infusion tests

1999 ◽  
Vol 15 (5) ◽  
pp. 213-217 ◽  
Author(s):  
Rachid Azeddine Bech ◽  
Lars Bøgeskov ◽  
Svend Erik Børgesen ◽  
Marianne Juhler
Keyword(s):  
Shunt Insertion ◽  
Iii Ventriculostomy ◽  
Intraventricular Infusion

scholarly journals Post-haemorrhagic hydrocephalus is associated with poorer surgical and neurodevelopmental sequelae than other causes of infant hydrocephalus

2021 ◽  
Author(s):  
Malak Mohamed ◽  
Saniya Mediratta ◽  
Aswin Chari ◽  
Cristine Sortica da Costa ◽  
Greg James ◽  
...  
Keyword(s):  
Gestational Age ◽  
Cox Regression ◽  
Severe Disabilities ◽  
Median Number ◽  
Shunt Revision ◽  
Endocrine Dysfunction ◽  
Neurodevelopmental Outcomes ◽  
Shunt Insertion ◽  
Street Hospital ◽  
Shunt Survival

Abstract Purpose This retrospective cohort study aimed to investigate the surgical and neurodevelopmental outcomes (NDO) of infant hydrocephalus. We also sought to determine whether these outcomes are disproportionately poorer in post-haemorrhagic hydrocephalus (PHH) compared to other causes of infant hydrocephalus. Methods A review of all infants with hydrocephalus who had ventriculoperitoneal (VP) shunts inserted at Great Ormond Street Hospital (GOSH) from 2008 to 2018 was performed. Demographic, surgical, neurodevelopmental, and other clinical data extracted from electronic patient notes were analysed by aetiology. Shunt survival, NDO, cerebral palsy (CP), epilepsy, speech delay, education, behavioural disorders, endocrine dysfunction, and mortality were evaluated. Results A total of 323 infants with median gestational age of 37.0 (23.29–42.14) weeks and birthweight of 2640 g (525–4684 g) were evaluated. PHH was the most common aetiology (31.9%) and was associated with significantly higher 5-year shunt revision rates, revisions beyond a year, and median number of revisions than congenital or “other” hydrocephalus (all p < 0.02). Cox regression demonstrated poorest shunt survival in PHH, related to gestational age at birth and corrected age at shunt insertion. PHH also had the highest rate of severe disabilities, increasing with age to 65.0% at 10 years, as well as the highest CP rate; only genetic hydrocephalus had significantly higher endocrine dysfunction (p = 0.01) and mortality rates (p = 0.04). Conclusions Infants with PHH have poorer surgical and NDO compared to all other aetiologies, except genetic hydrocephalus. Research into measures of reducing neurodisability following PHH is urgently required. Long-term follow-up is essential to optimise support and outcomes.

scholarly journals Letter: Transesophageal Echocardiography-Guided Ventriculoatrial Shunt Insertion

2020 ◽  
Vol 20 (1) ◽  
pp. E73-E73 ◽  
Author(s):  
Giuseppe Maria Della Pepa ◽  
Carmelo Lucio Sturiale ◽  
Vito Stifano
Keyword(s):  
Transesophageal Echocardiography ◽  
Ventriculoatrial Shunt ◽  
Shunt Insertion

Cerebrospinal fluid shunt insertion: techniques of peritoneal catheter placement separate from abdominal fascial and peritoneal incisions

2010 ◽  
Vol 113 (1) ◽  
pp. 79-81 ◽  
Author(s):  
Abdurrahim A. Elashaal ◽  
Michael Corrin ◽  
Michael D. Cusimano
Keyword(s):  
Abdominal Wall ◽  
Csf Shunt ◽  
Abdominal Wall Closure ◽  
Peritoneal Catheter ◽  
Effective Technique ◽  
Shunt Insertion ◽  
Risk Patients ◽  
Abdominal Operations ◽  
Insertion Techniques ◽  
Almost All

Good abdominal wall closure is one of the basic surgical skills and is a common feature of almost all modernday CSF shunt operations. The fact that some patients require multiple abdominal operations highlights the need for a simple and effective technique for peritoneal catheter insertion through the abdominal wall and abdominal wall closure. Although technically simple, abdominal wall closure becomes more complex when combined with the requirement to maintain CSF shunt function in cases in which the shunt catheter passes through the abdominal wall into the peritoneal cavity. In this report, the authors describe a simple technique for passing the peritoneal catheter of a ventriculoperitoneal shunt through the abdominal wall on a pathway separate from the fascial opening. This technique minimizes the risk of abdominal wall–related complications and is especially important in high-risk patients such as those with obesity and/or diabetes and in children.

Utility of CSF Pressure Monitoring to Identify Idiopathic Intracranial Hypertension without Papilledema in Patients with Chronic Daily Headache

Cephalalgia ◽  
2004 ◽  
Vol 24 (6) ◽  
pp. 495-502 ◽  
Author(s):  
MT Torbey ◽  
RG Geocadin ◽  
AY Razumovsky ◽  
D Rigamonti ◽  
MA Williams
Keyword(s):  
Intracranial Hypertension ◽  
Chronic Daily Headache ◽  
Idiopathic Intracranial Hypertension ◽  
Pulse Amplitude ◽  
Shunt Insertion ◽  
Csf Drainage ◽  
Plateau Waves ◽  
Objective Evidence ◽  
Diagnostic Role ◽  
Daily Headache

The aim of the present study was to report on the utility of continuous Pcsf monitoring in establishing the diagnosis of idiopathic intracranial hypertension without papilledema (IIHWOP) in chronic daily headache (CDH) patients. We report a series of patients ( n = 10) with refractory headaches and suspected IIHWOP referred to us for continuous Pcsf monitoring between 1991 and 2000. Pcsf was measured via a lumbar catheter and analysed for mean, peak, highest pulse amplitude and abnormal waveforms. A 1-2 day trial of continuous controlled CSF drainage (10 cc/h) followed Pcsf monitoring. Response to CSF drainage was defined as improvement in headache symptoms. Patients with abnormal waveforms underwent a ventriculoperitoneal (VPS) or lumboperitoneal (LPS) shunt insertion. All patients had normal resting Pcsf (8 ± 1 mmHg) defined as ICP < 15 mmHg. During sleep, all patients had B-waves and 90% had plateau waves or near plateau waves. All patients underwent either a VPS or LPS procedure. All reported improvement of their headache after surgery. Demonstration of pathological Pcsf patterns by continuous Pcsf monitoring was essential in confirming the diagnosis of IIHWOP, and provided objective evidence to support the decision for shunt surgery. Increased Pcsf was seen mostly during sleep and was intermittent, suggesting that Pcsf elevation may be missed by a single spot-check LP measurement. The similarity between IIHWOP and CDH suggests that continuous Pcsf monitoring in CDH patients may have an important diagnostic role that should be further investigated.

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