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VP shunt complications in hydrocephalus

Ashish Chugh, Sarang Gotecha, Gaurav Amle, Anil Patil, Prashant Punia, Megha Kotecha
Background: Ventriculoperitoneal (VP) shunt is commonly used in the treatment of hydrocephalus. Migration and extrusion of the distal end of the VP shunt are relatively rarely occurring complications. Aim: To retrospectively analyze patients with extrusion of the abdominal end of ventriculoperitoneal shunts and evaluate the possible etiology and outcome. Settings and Design: All patients presenting with extrusion of lower end of the shunt were included...
July 2018: Journal of Pediatric Neurosciences
Abigail J Rao, Zoe Teton, Victor Rodriguez, Brandon H Tieu, Ahmed M Raslan
BACKGROUND: Myelomeningocele patients with shunt-dependent hydrocephalus often require multiple shunt revisions, eventually exhausting first-line distal diversion sites. Ventriculoatrial (VA) shunts are used less commonly than ventriculoperitoneal (VP) shunts, but knowledge of their use and complications is important to the neurosurgeon's armamentarium. VA shunts differ from VP and ventriculopleural shunts in that the ideal distal catheter target is an anatomically small area in comparison to the peritoneal and pleural cavities...
September 25, 2018: World Neurosurgery
Neena I Marupudi, Carolyn Harris, Tanya Pavri, Brenna Mell, Rasanjeet Singh, Steven D Ham, Sandeep Sood
OBJECTIVE: Lumboperitoneal (LP) shunts have a role not only in pseudotumor cerebri, but also in patients with slit-like ventricles who are treated with CSF shunting on a chronic basis. Hesitation to utilize LP shunts is based on previous conventional beliefs including the tendency for overdrainage, difficulties accessing the shunt to tap or revise, and risk of progressive cerebellar tonsillar herniation. The authors hypothesized that the use of horizontal-vertical (HV) valves may reduce the risk of these complications, particularly overdrainage and development of Chiari malformation...
September 21, 2018: Journal of Neurosurgery. Pediatrics
Alberto Feletti, Domenico d'Avella, Carsten Wikkelsø, Petra Klinge, Per Hellström
BACKGROUND: Ventriculoperitoneal shunt (VP-shunt) is the standard of treatment for idiopathic normal pressure hydrocephalus (iNPH). However, a thorough investigation of VP-shunt complications in this population is lacking. OBJECTIVE: To present the analysis and the rates of complications progressively occurring during the first year after shunt surgery in the patients with iNPH included in the European multicenter (EU-iNPH) study. METHODS: Patients (n = 142) were prospectively included in the EU-iNPH study by 13 institutions...
August 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
Gregory Czajka, Halley Kreminski
Hydrocephalus can be the result of an infection, obstruction, impaired reabsorption of cerebrospinal fluid (CSF), or an abnormal increase in CSF. Ventriculoperitoneal (VP) shunting is the gold standard treatment for hydrocephalus despite its high rate of complications, including catheter obstruction and infection. Spontaneous cecal perforation by a VP shunt is extremely rare. Headache or subtle change in personality may indicate a VP shunt infection. Early recognition of the infection is critical for optimal patient outcomes...
September 2018: JAAPA: Official Journal of the American Academy of Physician Assistants
Pradyumna Pan
Aim: To study the clinical outcome of shunt surgeries in children with hydrocephalus and evaluate the risk factors for ventriculoperitoneal (VP) shunt failure. Materials and Methods: Patients who underwent VP shunt surgery for hydrocephalus were included. Medical charts, operative reports, imaging studies, and clinical follow-up evaluations were reviewed and analyzed retrospectively. Results: A total of 137 patients with the average age of 20...
April 2018: Journal of Pediatric Neurosciences
Muhammad Junaid, Mamoon Ahmed, Mamoon Ur Rashid
Objective: This study was conducted to assess outcomes in patients with hydrocephalus who underwent ventriculoperitoneal shunting at Keen's point. Methods: This retrospective study was conducted in Combined Military Hospital (CMH) Peshawar. Time frame was four years from January 2011 to January 2015. The presenting complaints, clinical findings, investigations, treatment plans and surgical outcomes were noted. Ventriculo-Peritoneal (VP) shunting was done at Keen's point...
May 2018: Pakistan Journal of Medical Sciences Quarterly
Ahmed A M Ezzat, Mohamed A R Soliman, Amr A Hasanain, Mohamed A Thabit, Hesham Elshitany, Haitham Kandel, Sameh H Abdel-Bari, Ahmed M F Ghoul, Ahmed Abdullah, Mohamed F M Alsawy, Ammar A Ghaleb, Ahmed Al Menabbawy, Ahmed A Marei, Bassante Abd El Razik, Henry W S Schroeder, Sascha Marx, Ahmed Zohdi, Ehab El Refaee
BACKGROUND: Ventriculoperitoneal (VP) shunting is the most commonly performed procedure in the treatment of hydrocephalus. VP shunt migration can occur at different sites. The aim of the study was to present different sites of abnormal distal shunt location, pathophysiology, and the management in each situation. METHODS: Between 2014 and 2017, all patients with hydrocephalus in the Department of Neurosurgery, Cairo University, were gathered prospectively. All pediatric patients below the age of 12 years with shunt migration of the distal end of the VP shunt were identified...
July 19, 2018: World Neurosurgery
Aodhnait S Fahy, Stephanie Tung, Maria Lamberti-Pasculli, James Drake, Abhaya V Kulkarni, Justin T Gerstle
INTRODUCTION: Ventriculoperitoneal shunts (VPSs) are the mainstay of treatment of hydrocephalus but have frequent complications including shunt failure and infection. There has been no comparison of laparoscopic versus open primary VPS insertion in children. We hypothesized that laparoscopic VP shunt insertion may improve patient outcomes. METHODS: A prospectively-maintained, externally-validated database of pediatric patients who underwent VPS insertion at a single center between 2012 and 2016 was reviewed...
July 6, 2018: Journal of Pediatric Surgery
Madoka Nakajima, Masakazu Miyajima, Ikuko Ogino, Chihiro Akiba, Kaito Kawamura, Michiko Kurosawa, Nagato Kuriyama, Yoshiyuki Watanabe, Wakaba Fukushima, Etsuro Mori, Takeo Kato, Hidenori Sugano, Kostadin Karagiozov, Hajime Arai
Background and Purpose: This study aimed to investigate the efficacy of cerebrospinal fluid shunt intervention for idiopathic normal pressure hydrocephalus (iNPH) using data from a nationwide epidemiological survey in Japan. Methods: We conducted a cross-sectional study using data from a nationwide epidemiological survey performed in Japan. Propensity score matching was used to select 874 patients from 1,423 patients aged ≥60 years, who were diagnosed with iNPH based on clinical guidelines following a hospital visit in 2012...
2018: Frontiers in Neurology
Cecilia L Dalle Ore, Peter Abraham, Luke P Burns, Samuel Lance, Amanda Gosman, Hal S Meltzer
Reconstructive cranioplasty can be associated with many complications and add to the not insignificant potential risks associated with decompressive craniectomy. In the setting of post-traumatic hydrocephalus, treatment with a ventriculoperitoneal (VP) shunt prior to reconstructive cranioplasty likely increases these risks even further. The authors report a case of a 17-year-old male with a history of a severe closed head injury who initially suffered a life-threatening complication associated with intracranial hypotension after cranioplasty only to succumb to malignant intracranial hypertension following a second cranioplasty attempt...
October 2018: Journal of Craniofacial Surgery
Maria Kamenova, Jonathan Rychen, Raphael Guzman, Luigi Mariani, Jehuda Soleman
Despite being widely used, ventriculoperitoneal (VP) shunt placement is a procedure often associated with complications and revision surgeries. Many neurosurgical centers routinely perform early postoperative cranial computer tomography (CT) to detect postoperative complications (e.g., catheter malposition, postoperative bleed, over-drainage). Because guidelines are lacking, our study aimed to evaluate the yield of early routine postoperative CT after shunt placement for adult hydrocephalus. We retrospectively reviewed 173 patients who underwent frontal VP shunting for various neurosurgical conditions...
2018: PloS One
Mohammed Aloddadi, Safar Alshahrani, Ibrahim Alnaami
The management of hydrocephalus represents a neurosurgical challenge. Ventriculoperitoneal (VP) shunts are usually the treatment of choice for hydrocephalus. However, when VP shunt is not an option, ventriculoatrial (VA) shunt becomes a second choice. VA shunts have special complications such as postoperative neck hematomas, shunt nephritis, and migration of the distal segment. There are two main techniques for the retrieval of migrated VA shunt: either by retrieval of the broken segment by thoracotomy, which is highly invasive, or by transvenous approach...
January 2018: Journal of Pediatric Neurosciences
Wutthiseth Dhitinanmuang, Piriyaporn Chongtrakool, Anupop Jitmuang
BACKGROUND: Cryptococcus gattii is known to be an etiologic agent of human cryptococcosis, particularly in immunocompetent persons. C. gattii infection usually involves the central nervous system, the respiratory tract, or may be disseminated. Here we report an atypical manifestation of C. gattii infection in a patient who had C. gattii meningitis complicating the ventriculoperitoneal (VP) shunt infection and concurrent infected intraabdominal VP shunt pseudocyst. CASE PRESENTATION: A 66-year-old Thai female was initially diagnosed with normal pressure hydrocephalus (NPH) and underwent programmable VP shunt placement...
June 4, 2018: BMC Infectious Diseases
Alexander Verhaeghe, Stijn De Muynck, Jan W Casselman, Nikolaas Vantomme
BACKGROUND: Pneumocephalus is usually seen in trauma or cranial surgery. It is rarely reported as a delayed complication of ventriculoperitoneal shunt placement for hydrocephalus secondary to trauma, tumor, or aqueduct stenosis. We describe a case of intraventricular pneumocephalus manifesting 10 months after placement of a shunt for normal-pressure hydrocephalus. CASE DESCRIPTION: A pressure-regulated ventriculoperitoneal shunt was implanted in an 81-year-old patient after diagnosis of normal-pressure hydrocephalus...
August 2018: World Neurosurgery
Federica Porcaro, Emidio Procaccini, Maria Giovanna Paglietti, Alessandra Schiavino, Francesca Petreschi, Renato Cutrera
BACKGROUND: Pleural effusion is a rare complication of ventriculo-peritoneal (VP) cerebrospinal fluid (CSF) shunting and its diagnosis is difficult in patients with neurological and consciousness impairment. CASE REPORT: Herein we report the case of a child affected by Pfeiffer syndrome and hydrocephalus, shunted at the age of 3 months, who developed acute respiratory failure due to a right-sided pleural effusion 2 years later. Plain chest radiographs and computed tomography (CT) showed the intrathoracic migration of the right VP shunt abdominal tip...
March 27, 2018: Italian Journal of Pediatrics
Tsung-Ming Su, Tsung-Han Lee, Shih-Wei Hsu
An 82-year-old woman underwent a ventriculoperitoneal (VP) shunt placement to treat hydrocephalus secondary to a right thalamic intracerebral hemorrhage. Pneumothorax and subcutaneous emphysema was noted 2 hours later. No respiratory distress was noted. A chest computed tomography scan revealed that the shunt tube had penetrated the diaphragm and entered the pleural space. The shunt tube penetrated the lung parenchyma and exited the pleural space via the third intercostal space. She underwent chest drainage and VP shunt reposition...
March 11, 2018: Turkish Neurosurgery
Mohammad Sadegh Masoudi, Marziye Rasafian, Zahra Naghmehsanj, Fariborz Ghaffarpasand
Ventriculoperitoneal (VP) shunting is mostly used in the treatment of hydrocephalus and many complications have been reported with this method. Abdominal Pseudocyst (APC) are relatively uncommon but important complications in patients with VP shunts. We herein report the case of a 9-year-old boy with VP shunt who presented with abdominal distension, abdominal pain, malaise, and decrease of appetite. Abdominal pelvic computed tomography confirmed a diagnosis of APC. Laparotomy was done and VP shunt was placed into the other side of peritoneal cavity again...
July 2017: African Journal of Paediatric Surgery: AJPS
Luis C Ascanio, Raghav Gupta, Nimer Adeeb, Justin M Moore, Christoph J Griessenauer, Julie Mayeku, Yaw Tachie-Baffour, Ranjit Thomas, Abdulrahman Y Alturki, Philip G R Schmalz, Christopher S Ogilvy, Ajith J Thomas
OBJECTIVE Currently, there is no established standard regarding the ideal number of external ventricular drain (EVD) clamp trials performed before ventriculoperitoneal (VP) shunt insertion following nontraumatic subarachnoid hemorrhage (SAH). In this study, the authors aimed to evaluate this relationship. METHODS A retrospective review of all patients presenting with SAH between July 2007 and December 2016 was performed. Patients with SAH who had received an EVD within the first 24 hours of hospital admission and had undergone at least 1 clamp trial prior to EVD removal were eligible for inclusion in the study...
March 16, 2018: Journal of Neurosurgery
Sharad Rajpal, Colson Tomberlin, Andrew Bauer, Robert C Forsythe, Sigita Burneikiene
BACKGROUND: Various diagnostic characteristics associated with neurocysticercosis have been well studied; however, their potential to be implicated in other differential diagnoses 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 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...
June 2018: World Neurosurgery
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