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Ventriculoperitoneal Shunt infections

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https://www.readbyqxmd.com/read/29325961/abdominal-pseudocysts-and-peritoneal-catheter-revisions-surgical-long-term-results-in-pediatric-hydrocephalus
#1
Matthias Gmeiner, Helga Wagner, Willem J R van Ouwerkerk, Wolfgang Senker, Kurt Holl, Andreas Gruber
OBJECTIVE: An abdominal pseudocyst (APC) is a distal catheter site specific failure in patients treated with ventriculoperitoneal shunts and few studies with more than ten patients have been reported. The aim of this study was to analyze causes of peritoneal catheter revisions with special emphasis on revisions due to an APC. METHODS: Pediatric patients with first shunt operation between 1982 and 1992 were included and time, cause and modality of peritoneal catheter revision were retrospectively determined...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29249076/endoscopic-third-ventriculostomy-in-children-with-a-fiber-optic-neuroendoscopy
#2
Wenjun Shen, Hasan R Syed, Gurpreet Gandhoke, Roxanna Garcia, Tatiana Pundy, Tadanori Tomita
OBJECTIVE: Endoscopic third ventriculostomy (ETV) provides a shunt-free treatment for obstructive hydrocephalus children. With rapidly evolving technology, the semi-rigid fiber optic neuroendoscopy shows a potential application in ETV by blunt fenestration. A retrospective analysis of our experience is reviewed. METHODS: The authors review infants and children who underwent ETV using this technique from June 2004 to June 2016 with radiological and clinical follow-up done by a single surgeon...
December 16, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29243978/reduction-of-shunt-dependency-rates-following-aneurysmal-subarachnoid-hemorrhage-by-tandem-fenestration-of-the-lamina-terminalis-and-membrane-of-liliequist-during-microsurgical-aneurysm-repair
#3
Ethan A Winkler, Jan-Karl Burkhardt, W Caleb Rutledge, Jonathan W Rick, Carlene P Partow, John K Yue, Harjus Birk, Ashley M Bach, Kunal P Raygor, Michael T Lawton
OBJECTIVE Shunt-dependent hydrocephalus is an important cause of morbidity following aneurysmal subarachnoid hemorrhage (aSAH) in excess of 20% of cases. Hydrocephalus leads to prolonged hospital and ICU stays, well as to repeated surgical interventions, readmissions, and complications associated with ventriculoperitoneal (VP) shunts, including shunt failure and infection. Whether variations in surgical technique at the time of aneurysm treatment may modify rates of shunt dependency remains a matter of debate...
December 15, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29210159/safety-of-mtor-inhibitor-continuation-in-pediatric-heart-transplant-recipients-undergoing-surgical-procedures
#4
Ann Heble, Melanie D Everitt, Jane Gralla, Shelley D Miyamoto, Michael Lahart, Jennifer Eshelman
mTOR inhibitors have been associated with SWC when used in the perioperative period. Limited literature is available to guide providers in managing chronic mTOR inhibitor use in the perioperative period, especially in the pediatric setting. The primary aim of this study was to describe the prevalence of SWC with mTOR inhibitor continuation during the perioperative period for major surgeries. Heart transplant recipients ≤25 years old at the time of primary heart transplant receiving sirolimus maintenance therapy during a surgical procedure and within the study period were included...
December 6, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29204210/spontaneous-umbilical-csf-fistula-due-to-migration-of-the-peritoneal-end-of-vp-shunt-a-case-report-and-review-of-pathogenesis
#5
Siddharth Vankipuram, Somil Jaiswal, Manish Jaiswal, Ankur Bajaj, Anil Chandra, B K Ojha
Abdominal complications after ventriculoperitoneal (VP) shunt surgery for hydrocephalus have been known to occur. The more common complications include peritoneal pseudocyst, obstruction of the lower end, and shunt infection. Perforations of the intra-abdominal hollow viscera leading to spontaneous extrusions of the peritoneal catheter via the natural orifices have also been reported. A rarer phenomenon still is the migration of the lower end of the VP shunt through the anterior abdominal wall, leading to the formation of a spontaneous umbilical fistula at a site unrelated to the surgical site...
July 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/29184708/solitary-aggregatibacter-aphrophilus-tectal-abscess-in-an-immunocompetent-patient
#6
Tianyi Niu, Alexander M Tucker, Daniel T Nagasawa, Marvin Bergsneider
Background: A solitary abscess involving the tectum, specifically by Aggregatibacter aphrophilus, is an extremely rare condition with no known reported cases to date. Case Description: Here, we present a case of isolated solitary midbrain tectum abscess in an immunocompetent 28-year-old male who was empirically diagnosed as a primary tectal tumor at an outside hospital where he also underwent placement of a ventriculoperitoneal shunt (VPS) for obstructive hydrocephalus...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29159427/shunt-revision-rates-in-myelomeningocele-patients-in-the-first-year-of-life-a-retrospective-study-of-52-patients
#7
Ibrahim Alatas, Gokhan Canaz, Nesrin Akkoyun Kayran, Nursu Kara, Huseyin Canaz
PURPOSE: Shunt placement indications are stringent and require confirmation of clinical and radiological evidence of hydrocephalus (HC). The aim of this study was to determine the rate of shunting and discuss the outcome in the first year of life in patients with myelomeningocele (MMC) on the basis of review of the literature. METHODS: All patients who underwent postnatal repair of MMC at our institution between March 2014 and March 2015 were evaluated. Patients were only included if they underwent both MMC repair and ventriculoperitoneal (VP) shunt insertion at our institution and were followed up for at least 12 months...
November 20, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29125410/hemorrhage-associated-with-ventriculoperitoneal-shunt-placement-in-aneurysmal-subarachnoid-hemorrhage-patients-on-a-regimen-of-dual-antiplatelet-therapy-a-retrospective-analysis
#8
Joseph S Hudson, Yasunori Nagahama, Daichi Nakagawa, Robert M Starke, Brian J Dlouhy, James C Torner, Pascal Jabbour, Lauren Allan, Colin P Derdeyn, Jeremy D W Greenlee, David Hasan
OBJECTIVE Intracranial stenting and flow diversion require the use of dual antiplatelet therapy (DAPT) to prevent in-stent thrombosis. DAPT may significantly increase the risk of hemorrhagic complications in patients who require subsequent surgical interventions. In this study, the authors sought to investigate whether DAPT is a risk factor for hemorrhagic complications associated with ventriculoperitoneal (VP) shunt placement in patients with aneurysmal subarachnoid hemorrhage (aSAH). Moreover, the authors sought to compare VP shunt complication rates with respect to the shunt's location from the initial external ventricular drain (EVD) site...
November 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29114279/comparison-between-ventriculosubgaleal-shunt-and-extraventricular-drainage-to-treat-acute-hydrocephalus-in-adults
#9
Low Siaw Nee, Rahmat Harun, Pulivendhan Sellamuthu, Zamzuri Idris
Context: Hydrocephalus, due to subarachnoid or intraventricular hemorrhage (IVH), meningitis, or tumor compression, is usually transient and may resolve after treatment. There are several temporary methods of cerebrospinal fluid (CSF) diversion, none of it is superior to the other, and the decision is based on its various etiologies and factors. Ventriculosubgaleal shunt (VSGS) is one of those temporary measures, which is a simple and rapid CSF decompression method without causing electrolyte and nutritional losses...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29110198/surgical-management-of-craniosynostosis-in-the-setting-of-a%C3%A2-ventricular-shunt-a-case-series-and-treatment-algorithm
#10
Michael S Golinko, Danielle N Atwood, Eylem Ocal
PURPOSE: Cerebrospinal fluid diversion via ventricular shunt is a common treatment for hydrocephalus. Change in cranial morphology associated with a sutural fusion has been termed shunt-related or induced craniosynostosis (SRC) or craniocerebral disproportion (CCD). We present a series of patients with SRC who underwent cranial vault remodeling (CVR) and our treatment algorithm. METHODS: Thirteen patients were retrospectively reviewed who had SRC and CVR; 92% of patients had a ventriculoperitoneal (VP) shunt placed for largely intraventricular hemorrhage of prematurity (69% of patients) at a mean age of 2...
November 6, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29109928/ventriculoperitoneal-shunt-associated-vancomycin-resistant-meningitis-complicating-a-patient-undergoing-plasmapheresis-for-presumed-systemic-lupus-erythematosus-associated-transverse-myelitis
#11
Adam John Covach, William Nicholas Rose
Objectives  We report a patient who had a working diagnosis of transverse myelitis secondary to a lupus exacerbation. As his clinical course evolved, continued vigilance clarified that he was in fact suffering from a nosocomial infection caused by vancomycin-resistant Enterococcus (VRE). Methods  We performed a retrospective review of the patient's medical record. Results  Despite radiographic improvement, he did not improve clinically following immunosuppressive therapy including plasma exchange. Once meningitis was diagnosed and treated, he improved rapidly...
October 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/29057856/migration-of-the-distal-catheter-of-the-ventriculoperitoneal-shunt-in-hydrocephalus-patients
#12
Mohammed Z Allouh, Mohammed M Al Barbarawi, Mohammed H Hiasat, Bashar A Abuzayed
Distal catheter migration of a ventriculoperitoneal shunt (VPS) is a rare but serious complication. It is usually asymptomatic. However, it can be further complicated by the presence of co-infections, interruption of the shunt, and/or disturbances in penetrated organ function. In this report, we presented a case of spontaneous complete extrusion of the distal end of a VPS catheter through the intact abdominal wall in a 5-year-old boy with hydrocephalus. We also reviewed and analyzed the literature for similar cases of complete extrusion of the distal end of a VPS catheter, through an intact or a potential weakness in the body wall, in the last 20 years...
October 2017: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/29042927/novel-type-of-peritoneocentesis-trocar-assisted-distal-ventriculoperitoneal-shunt-placement-with-supervision-via-a-one-port-laparoscope
#13
Guangming Wang, Jinlu Yu, Yongxin Luan, Yanwu Han, Shuanglin Fu
Ventriculoperitoneal shunts (VPS) are the primary treatment for hydrocephalus and are associated with a high risk of complications, specifically in patients who are obese or have abdominal adhesions or shunt revisions. The present study describes the use of a novel type of peritoneal catheter peritoneocentesis trocar insertion with the assistance of a one-port laparoscope. A total of 36 patients with hydrocephalus underwent this novel type of peritoneocentesis trocar-assisted VPS. The distal shunt catheter was placed into the right subdiaphragmatic space and the catheter was traversed through a single hole drilled through the liver falciform ligament...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29037257/ventriculoperitoneal-shunt-insertion-for-hydrocephalus-in-human-immunodeficiency-virus-infected-adults-a-systematic-review-and-meta-analysis-protocol
#14
James J M Loan, Ncedile Mankahla, Graeme Meintjes, A Graham Fieggen
BACKGROUND: Hydrocephalus is a recognised complication of human immunodeficiency virus (HIV)-related opportunistic infections. Symptomatic raised cerebrospinal fluid pressure can be treated with ventriculoperitoneal shunt insertion (VPS). In HIV-infected patients however, there is a concern that VPS might be associated with unacceptably high rates of mortality. We aim to systematically review and appraise published literature to determine reported outcomes and identify predictors of outcome following VPS in relevant subgroups of HIV-infected adults...
October 16, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29027589/diagnosis-and-treatment-of-severe-neurosurgical-patients-with-pyogenic-ventriculitis-caused-by-gram-negative-bacteria
#15
Feng Shang, Yueqiao Xu, Ning Wang, Weitao Cheng, Wenjin Chen, Wanru Duan
The aim of the study is to explore the experiences in diagnosis and treatment of severe neurosurgical patients with pyogenic ventriculitis caused by gram-negative bacteria (G(-)). Nineteen patients with pyogenic ventriculitis were reviewed for their treatment. The bacterial testing results of cerebrospinal fluid (CSF), the clinical intervention, and the patients' prognosis were evaluated. The bacterial smears of ventricular drainage from all the cases were G(-) bacteria. Head CT and MRI scans confirmed that they were intraventricular empyema...
October 13, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/29025781/subclinical-meningoventriculitis-as-a-cause-of-obstructive-hydrocephalus
#16
Ravindran Visagan, Laurent James Livermore, Dominic Kelly, Shailendra Magdum
Communicating hydrocephalus may complicate infantile bacterial meningitis, typically presenting with systemic features of infection. We report a rare case of 'subclinical meningoventriculitis' causing obstructive hydrocephalus and its challenging management. A healthy 10-week-old immunocompetent male patient presented with failure to thrive and vomiting, secondary to presumed gastro-oesophageal reflux. The child was neurologically alert, afebrile with normal inflammatory markers. Progressive macrocephaly prompted an MRI confirming triventricular hydrocephalus secondary to aqueductal stenosis...
October 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28993858/treatment-of-abdominal-pseudocysts-and-associated-ventricuoperitoneal-shunt-failure
#17
Emily Dzongowski, Kamary Coriolano, Sandrine de Ribaupierre, Sarah A Jones
PURPOSE: The purpose of this study was to determine whether drainage and revision are an effective treatment for abdominal pseudocyst associated ventriculoperitoneal (VP) shunt failure by estimating the total rate of secondary shunt failure. METHODS: We performed a retrospective review of children with hydrocephalus diagnosed with and treated for an abdominal pseudocyst at the Children's Hospital, London Health Sciences Centre (LHSC) between January 1, 2000 and May 31, 2016 (ethics approval # 108136)...
December 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28965232/the-role-of-simultaneous-abdominal-surgery-and-wound-classification-in-ventriculoperitoneal-shunt-complication
#18
Shin Miyata, Jamie Golden, Olga Lebedevskiy, James E Stein, David W Bliss
PURPOSE: To evaluate whether simultaneous abdominal surgery or wound contamination at the time of ventriculoperitoneal (VP) shunt placement are associated with increased shunt complications. METHODS: Pediatric patients who underwent VP shunt placement were identified using the National Surgical Quality Improvement Program Pediatric database. VP shunt complication rates were compared between patients who underwent simultaneous abdominal surgeries at the time of VP shunt placement vs those who did not and between those with clean/clean-contaminated and contaminated/dirty wound classifications...
November 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28917602/comparing-inpatient-versus-outpatient-bowel-preparation-in-children-and-adolescents-undergoing-appendicovesicostomy
#19
David L Weatherly, Konrad M Szymanski, Benjamin M Whittam, William E Bennett, Shelly King, Rosalia Misseri, Martin Kaefer, Richard C Rink, Mark P Cain
PURPOSE: The need for mechanical inpatient bowel preparation (IBP) in reconstructive pediatric urology has come under scrutiny, secondary to literature demonstrating little benefit regarding outcomes. Starting in 2013, a majority of patients undergoing reconstructive procedures at our institution no longer underwent IBP. We hypothesized that outpatient bowel preparation (OBP) would reduce length of stay (LOS) without increasing postoperative complications after appendicovesicostomy surgery...
August 26, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28885096/infant-hydrocephalus-in-sub-saharan-africa-the-reality-on-the-tanzanian-side-of-the-lake
#20
Maria M Santos, Derick K Rubagumya, Imani Dominic, Amos Brighton, Soledad Colombe, Philip O'Donnell, Micaella R Zubkov, Roger Härtl
OBJECTIVE Infant hydrocephalus is estimated to affect more than 100,000 new infants each year in sub-Saharan Africa (SSA). Bugando Medical Centre (BMC), a government-funded and patient cost-shared referral center, serves over 13 million people in the Lake and Western regions of Tanzania. The goals of this study were to characterize the infant population affected by hydrocephalus who presented to BMC and were treated with a ventriculoperitoneal shunt (VPS) to determine the rate of early complications associated with this surgical procedure and to assess its potential risk factors...
November 2017: Journal of Neurosurgery. Pediatrics
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