Cerebrospinal Fluid Shunt Failure: Late Is Different from Early

1995 ◽  
Vol 23 (3) ◽  
pp. 133-139 ◽  
Author(s):  
Joseph H. Piatt, Jr.
Keyword(s):  
Cerebrospinal Fluid ◽  
Shunt Failure ◽  
Cerebrospinal Fluid Shunt

T-Connector Modification for Reducing Recurrent Distal Shunt Failure: Report of 2 Cases

2017 ◽  
Vol 13 (6) ◽  
pp. E33-E36
Author(s):  
Joseph A Carnevale ◽  
Nigar Ahmedli ◽  
John F Morrison ◽  
Wael F Asaad ◽  
Petra Klinge ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Peritoneal Cavity ◽  
Clinical Presentation ◽  
The Body ◽  
Abdominal Pressure ◽  
Obese Patients ◽  
Shunt Failure ◽  
Cerebrospinal Fluid Shunt ◽  
Peritoneal Catheter ◽  
Distal Catheter

Abstract BACKGROUND AND IMPORTANCE Cerebrospinal fluid shunt placement is used to treat the various causes of hydrocephalus by redirecting the cerebrospinal fluid to the body, most commonly from the ventricle to the peritoneum. Distal catheter displacement from the peritoneal cavity can occur as a complication, necessitating reoperation. CLINICAL PRESENTATION We report 2 such cases in obese patients involving retropulsion of the distal tubing. To address this complication, we implanted a T-connector to the distal catheter construct. CONCLUSION This study supports the use of a T-connector catheter construct to decrease and prevent the possibility of distal peritoneal catheter retropulsion in cases of elevated intra-abdominal pressure, both prophylactically and in revisions.

Mechanical complications of cerebrospinal fluid shunt. Differences between adult and pediatric populations: myths or reality?

2021 ◽  
Author(s):  
Guillaume Coll ◽  
Francis Abed Rabbo ◽  
Emmanuel de Schlichting ◽  
Aurélien Coste ◽  
Jean Chazal ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebrospinal Fluid Shunt ◽  
Mechanical Complications ◽  
Pediatric Populations

scholarly journals Cerebrospinal fluid biomarkers of neuroinflammation in children with hydrocephalus and shunt malfunction

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Carolyn A. Harris ◽  
Diego M. Morales ◽  
Rooshan Arshad ◽  
James P. McAllister ◽  
David D. Limbrick
Keyword(s):  
Cerebrospinal Fluid ◽  
Inflammatory Cytokines ◽  
Protein Concentration ◽  
Shunt Revision ◽  
Csf Shunt ◽  
Shunt Failure ◽  
Revision Operation ◽  
Protein Levels ◽  
Anti Inflammatory ◽  
Pro Inflammatory Cytokines

Abstract Background Approximately 30% of cerebrospinal fluid (CSF) shunt systems for hydrocephalus fail within the first year and 98% of all patients will have shunt failure in their lifetime. Obstruction remains the most common reason for shunt failure. Previous evidence suggests elevated pro-inflammatory cytokines in CSF are associated with worsening clinical outcomes in neuroinflammatory diseases. The aim of this study was to determine whether cytokines and matrix metalloproteinases (MMPs) contribute towards shunt failure in hydrocephalus. Methods Using multiplex ELISA, this study examined shunt failure through the CSF protein concentration profiles of select pro-inflammatory and anti-inflammatory cytokines, as well as select MMPs. Interdependencies such as the past number of previous revisions, length of time implanted, patient age, and obstruction or non-obstruction revision were examined. The pro-inflammatory cytokines were IL-1β, IL-2, IL-5, IL-6, IL-8, IL-12, IL-17, TNF-α, GM-CSF, IFN-γ. The anti-inflammatory cytokines were IL-4 and IL-10, and the MMPs were MMP-2, MMP-3, MMP-7, MMP-9. Protein concentration is reported as pg/mL for each analyte. Results Patient CSF was obtained at the time of shunt revision operation; all pediatric (< 18), totaling n = 38. IL-10, IL-6, IL-8 and MMP-7 demonstrated significantly increased concentrations in patient CSF for the non-obstructed subgroup. Etiological examination revealed IL-6 was increased in both obstructed and non-obstructed cases for PHH and congenital hydrocephalic patients, while IL-8 was higher only in PHH patients. In terms of number of past revisions, IL-10, IL-6, IL-8, MMP-7 and MMP-9 progressively increased from zero to two past revisions and then remained low for subsequent revisions. This presentation was notably absent in the obstruction subgroup. Shunts implanted for three months or less showed significantly increased concentrations of IL-6, IL-8, and MMP-7 in the obstruction subgroup. Lastly, only patients aged six months or less presented with significantly increased concentration of IL-8 and MMP-7. Conclusion Non-obstructive cases are reported here to accompany significantly higher CSF cytokine and MMP protein levels compared to obstructive cases for IL-10, IL-6, IL-8, MMP-7 and MMP-9. A closer examination of the definition of obstruction and the role neuroinflammation plays in creating shunt obstruction in hydrocephalic patients is suggested.

scholarly journals Evaluation of Microbial Bacterial and Fungal Diversity in Cerebrospinal Fluid Shunt Infection

PLoS ONE ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e83229 ◽  
Author(s):  
Tamara D. Simon ◽  
Christopher E. Pope ◽  
Samuel R. Browd ◽  
Jeffrey G. Ojemann ◽  
Jay Riva-Cambrin ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Fungal Diversity ◽  
Shunt Infection ◽  
Cerebrospinal Fluid Shunt

Subdural hemorrhage of the cauda equina. A rare complication of cerebrospinal fluid shunt. Case report

1996 ◽  
Vol 19 (2) ◽  
pp. 113-117 ◽  
Author(s):  
Gabriele Wurm ◽  
Peter Pogady ◽  
Karin Lungenschmid ◽  
Johannes Fischer
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Rare Complication ◽  
Cauda Equina ◽  
Subdural Hemorrhage ◽  
Cerebrospinal Fluid Shunt

scholarly journals Favorable Outcome of Neonatal Cerebrospinal Fluid Shunt-Associated Candida Meningitis with Caspofungin

2013 ◽  
Vol 57 (5) ◽  
pp. 2391-2393 ◽  
Author(s):  
Jop Jans ◽  
Roger J. M. Brüggemann ◽  
V. Christmann ◽  
Paul E. Verweij ◽  
Adilia Warris
Keyword(s):  
Cerebrospinal Fluid ◽  
Medical Devices ◽  
Systemic Exposure ◽  
Favorable Outcome ◽  
Cerebrospinal Fluid Shunt ◽  
Device Removal ◽  
Content Type ◽  
Pharmacokinetic Assessment ◽  
Complex Cases

ABSTRACTInvasiveCandidainfections associated with medical devices are very difficult to cure without device removal. We present a case of neonatal cerebrospinal fluid shunt-associatedCandidameningitis, in which removal of the device was precluded, that was successfully treated with caspofungin. Pharmacokinetic assessment of caspofungin concentrations in cerebrospinal fluid showed that exposure was adequate in the presence of a high systemic exposure. In complex cases of neonatalCandidainfections involving medical devices, the addition of caspofungin might be beneficial.

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