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Ventriculoperitoneal Shunt infections

Sharad Rajpal, Colson Tomberlin, Andrew Bauer, Robert C Forsythe, Sigita Burneikiene
BACKGROUND: The variety of diagnostic characteristics associated with neurocysticercosis have been well studied, however, its potential to be implicated in other differential diagnosis has not been well demonstrated. CASE DESCRIPTION: We report the case of a 55-year-old Hispanic man who underwent a Chiari decompression surgery, which was complicated with hydrocephalus. Despite a ventriculoperitoneal (VP) shunt placement, he continued to have headaches and was soon found to have several skull base subarachnoid lesions, which were later diagnosed as the sequelae of an active neurocysticercosis infection...
March 12, 2018: World Neurosurgery
Mohammad Vafaee Shahi, Samileh Noorbakhsh, Vida Zarrabi, Banafsheh Nourozi, Leila Tahernia
Background: Any mismatch between the production and absorption of CSF results in hydrocephalus. In most cases, the selected choice of treatment is the ventriculoperitoneal shunt insertion. Although, the surgery could have complications such as infection, shunt malfunction, subdural hematoma, seizure and Shunt immigration; so, the early and proper detection of these complications could result in better prognosis. The aim of this study was to evaluate and compare the efficacy of CT scan, CSF analysis and X-ray radiography in detection of shunt complications and problems in shunt placement and further follow-up in hospitalized children...
2018: Open Neuroimaging Journal
Shraddha Siwakoti, Rinku Sah, Rupa Singh Rajbhandari, Basudha Khanal
Introduction: Pantoea agglomerans, primarily an environmental and agricultural organism has been reported as both commensal and pathogen of humans. We present two case reports of P. agglomerans infections in children that involved the meninges and bloodstream. Case Presentations: A 6-month-old female baby, diagnosed as congenital hydrocephalus secondary to aqueduct stenosis with ventriculoperitoneal shunt in situ, operated 14 days back was brought to the pediatric emergency with a two-day history of high fever associated with vomiting, irritability, excessive crying, and decreased feeding...
2018: Case Reports in Pediatrics
N G Jun Jie, Kok Ann Teo, Asim Shabbir, Tseng Tsai Yeo
Intra-abdominal metastasis (IAM) of central nervous system (CNS) tumors via ventriculoperitoneal shunt (VPS) is rare but has been previously reported (e.g., germinomas and medulloblastomas). However, there has been no previous report in the literature involving meningiomas. A case of primary rhabdoid meningioma with widespread intra-abdominal carcinomatosis after placement of a VPS in a 36-year-old man is described. The patient underwent preoperative angioembolization of the tumor, craniotomy, and surgical excision, followed by postoperative gamma knife radiosurgery...
January 2018: Asian Journal of Neurosurgery
Murat Şakir Ekşi, Ahmet Öğrenci, Osman Ersegun Batçık, Orkun Koban
De novo obstructive hydrocephalus is a rare event during pregnancy. There are only case reports presented in literature. We aimed to discuss the pathophysiological basis and management options with an exemplary case presentation and review of the current literature. A 28-year-old G2P1 patient presented to our clinic with headache, vomiting, and deteriorated vision at the 8th week of gestation. She had no history of central nervous system infection or trauma. A brain magnetic resonance imaging was obtained. There was hydrocephalus due to cerebral aqueduct stenosis (Evan's index of 58%)...
January 2018: Asian Journal of Neurosurgery
Sarah B Cairo, Justice Agyei, Kavira Nyavandu, David H Rothstein, Luc Malemo Kalisya
PURPOSE: Evaluate the management of hydrocephalus in pediatric patients in the Eastern Democratic Republic of Congo by a general surgeon. METHODS: Retrospective review of a single institution in the province of North Kivu. Patient charts and surgical notes were reviewed from 2003 to 2016. RESULTS: 116 procedures were performed for an average of 8.9 per year. 51.7% of surgeries were on female patients with an average age of 13.6 ± 22.7...
February 16, 2018: Pediatric Surgery International
Ruiping Zhang, Jungang Liu, Yizheng Wang, Lirong Cao, Chunquan Cai
The most common procedure to deal with hydrocephalus is ventriculoperitoneal (VP) shunt. The purpose of the shunt is to drain cerebrospinal fluid from cerebral ventricles to abdominal cavity. Many complications of VP shunts have been reported such as infection, obstruction, overdrainage. Abdominal complications occur in ~15-25% of VP shunts in pediatric patients, such as peritonitis, hernia, abscess, perforated colon, perforated bladder and abdominal pseudocyst. However, sub-capsular effusion of liver is a rare complication of VP shunt...
October 2017: Journal of Surgical Case Reports
Osman Akdag
PURPOSE: The exposure of a ventriculoperitoneal shunt on the scalp is a serious complication. There are limited studies evaluating this complication's management in the literature. The aim of this study is to define the management of shunt salvage and the reconstruction of the scalp. METHODS: This retrospective study included seven pediatric patients with ventriculoperitoneal shunts that were exposed on the scalp for various reasons. The demographic characteristics of the patients and the medical and surgical treatments used were recorded...
February 2, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Michael Karsy, Hussam Abou-Al-Shaar, Christian A Bowers, Richard H Schmidt
OBJECTIVE Idiopathic intracranial hypertension (IIH), or pseudotumor cerebri, is a complex and difficult-to-manage condition that can lead to permanent vision loss and refractory headaches if untreated. Traditional treatment options, such as unilateral ventriculoperitoneal (VP) or lumboperitoneal (LP) shunt placement, have high complication and failure rates and often require multiple revisions. The use of bilateral proximal catheters has been hypothesized as a method to improve shunt survival. The use of stereotactic technology has improved the accuracy of catheter placement and may improve treatment of IIH, with fewer complications and greater shunt patency time...
February 2, 2018: Journal of Neurosurgery
Mehmet Arslan, Abdurrahman Aycan, Ismail Gulsen, Mehmet Edip Akyol, Fetullah Kuyumcu
OBJECTIVE: The purpose of this retrospective study was to clarify the relationship of shunt infection to childhood hydrocephalus etiology. METHODS: We analyzed 1021 patients with childhood hydrocephalus who underwent V-P shunting over a period of approximately 15 years. The etiology of 1021 patients include myelomeningocele (794 patient), congenital (165 patient) and intraventricular haemorrhage (62 patient). RESULTS: Of the 1021 patients who underwent V-P shunting, 19...
January 2018: JPMA. the Journal of the Pakistan Medical Association
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
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
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
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...
February 2018: Pediatric Transplantation
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
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
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
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
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
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
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