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Ventricular shunt

Mark R Kraemer, Joyce Koueik, Susan Rebsamen, David A Hsu, M Shahriar Salamat, Susan Luo, Sara Saleh, Taryn M Bragg, Bermans J Iskandar
OBJECTIVE Ventricular shunts have an unacceptably high failure rate, which approaches 50% of patients at 2 years. Most shunt failures are related to ventricular catheter obstruction. The literature suggests that obstructions are caused by in-growth of choroid plexus and/or reactive cellular aggregation. The authors report endoscopic evidence of overdrainage-related ventricular tissue protrusions ("ependymal bands") that cause partial or complete obstruction of the ventricular catheter. METHODS A retrospective review was completed on patients undergoing shunt revision surgery between 2008 and 2015, identifying all cases in which the senior author reported endoscopic evidence of ependymal tissue in-growth into ventricular catheters...
August 17, 2018: Journal of Neurosurgery. Pediatrics
Fernando de Freitas Martins, Daniel Ibarra Rios, Maura Helena F Resende, Henna Javed, Dany Weisz, Amish Jain, Jose Maria de Andrade Lopes, Patrick J McNamara
OBJECTIVE: To define the technique of estimating ductal diameter (DD) that best correlates with echocardiographic markers of transductal shunt volume in preterm infants >7 days old with persistent patent ductus arteriosus (PDA). STUDY DESIGN: We conducted a retrospective study of 104 neonates born at <30 weeks gestation that had targeted neonatal echocardiography evaluation of PDA performed between 7 and 30 days. We used univariate analysis to determine the association of echocardiographic markers of shunt volume with ductal size definitions: DD, DD indexed to weight, and DD indexed to left pulmonary artery diameter...
August 13, 2018: Journal of Pediatrics
Michael C Burger, Marlies Wagner, Kea Franz, Patrick N Harter, Oliver Bähr, Joachim P Steinbach, Christian Senft
Ventriculoperitoneal shunts equipped with a reservoir and a valve to manually switch off the shunt function can be used for intraventricular injections of therapeutics in patients suffering from a communicating hydrocephalus caused by leptomeningeal metastases. These shunt devices avoid the risk of injecting therapeutics through the distal leg of the shunt system into the intraperitoneal space, which may cause toxicity. Furthermore, regular intraventricular injections of chemotherapeutics help to maintain sufficient concentrations in the ventricular space...
August 14, 2018: Journal of Clinical Medicine
Mohamed Khoulali, Mohammed Yasssine Haouas, Jihad Mortada, Robin Srour
Chronic hydrocephalus associated with a tumor of the conus medullaris and/or of the cauda equina is extremely rare. We here report two cases of medullary tumor revealed by the triad: dementia, difficulty walking and urinary incontinence. Magnetic resonance imaging (MRI) of the cerebrospinal fluid showed communicating hydrocephalus and intradural spinal tumors at the level of the conus medullaris and of the cauda equina. Surgical resection of a benign schwannoma and of an ependymoma allowed the resolution of the clinical symptomatology due to hydrocephalus without implantation of ventricular shunt...
2018: Pan African Medical Journal
Simone Peraio, Mohamed Mohsen Amen, Nabil Mansour Ali, Ahmed Zaher, Ahmed Nageeb Mohamed Taha, Gianpiero Tamburrini
OBJECTIVE: To define the role of neuroendoscopy as an adjuvant technique for the management of pediatric complex hydrocephalus METHODS: The authors performed a retrospective analysis of a series of pediatric patients operated on for complex hydrocephalus between January 2002 and March 2017 in two pediatric neurosurgery units, Gemelli Hospital, Catholic University of Sacred Heart, Rome, Italy, and Mansoura University Hospitals, Mansoura, Egypt. The endoscopic procedures performed included cyst or membrane fenestration, septum pellucidotomy, foraminoplasty, aqueductoplasty with or without stent; in selected cases, an ETV was performed as a combined procedure...
July 31, 2018: World Neurosurgery
Rajiv R Iyer, Noah Gorelick, Karen Carroll, Ari M Blitz, Sarah Beck, Caroline M Garrett, Audrey Monroe, Betty Tyler, Sean T Zuckerman, Jeffrey R Capadona, Horst A von Recum, Mark G Luciano
OBJECTIVE Ventricular shunt infection remains an issue leading to high patient morbidity and cost, warranting further investigation. The authors sought to create an animal model of shunt infection that could be used to evaluate possible catheter modifications and innovations. METHODS Three dogs underwent bilateral ventricular catheter implantation and inoculation with methicillin-sensitive Staphylococcus aureus ( S. aureus). In 2 experimental animals, the catheters were modified with a polymer containing chemical "pockets" loaded with vancomycin...
August 3, 2018: Journal of Neurosurgery
Willem P de Boode, Yogen Singh, Zoltan Molnar, Ulf Schubert, Marilena Savoia, Arvind Sehgal, Philip Levy, Patrick McNamara, Afif El-Khuffash
Pulmonary hypertension contributes to morbidity and mortality in both the term newborn infant, referred to as persistent pulmonary hypertension of the newborn (PPHN), and the premature infant, in the setting of abnormal pulmonary vasculature development and arrested growth. In the term infant, PPHN is characterized by the failure of the physiological postnatal decrease in pulmonary vascular resistance that results in impaired oxygenation, right ventricular failure, and pulmonary-to-systemic shunting. The pulmonary vasculature is either maladapted, maldeveloped, or underdeveloped...
July 2018: Pediatric Research
Daichi Akiyama, Takashi Nishimura, Hirohito Sumikura, Kei Iizuka, Toshihide Mizuno, Tomonori Tsukiya, Yoshiaki Takewa, Minoru Ono, Eisuke Tatsumi
Aortic insufficiency (AI) is an intractable complication during long term left ventricular assist device (LVAD) support. Conventional evaluation of AI depends on ultrasound evaluation, which is mainly a qualitative, not a quantitative method. The pathophysiology of AI during LVAD is shunt formation. Conversely, the methods to quantify the shunt of congenital heart disease are already established, and among these is the thermodilution technique. To develop an accurate quantification method for AI (namely, a shunt), we have adopted this conventional thermodilution technique...
July 31, 2018: Artificial Organs
Dennis H VanLoozen, Kenneth A Murdison, Anastasios C Polimenakos
Right ventricle dependent coronary circulation (RVDCC) in pulmonary atresia with intact ventricular septum (PA/IVS) is associated with significant mortality risk in the immediate post-operative period following the initial stage of surgical palliation. Prognosis remains guarded during the interstage period towards conversion to the superior cavopulmonary shunt physiology. Current literature is scarce regarding this specific patient population. Cardiac troponin-I is widely used as a marker of coronary ischemia in adults, but its use for routine monitoring of neonatal myocardial tissue injury due to supply/demand perfusion mismatch is, yet to be determined...
July 28, 2018: Pediatric Cardiology
Cristiane Felix Ximenes Pessotti, Paula Rodrigues Silva Machado Costa, Natalia de Freitas Jatene Baranauskas, Thalyta Madeira Correa, Ieda Biscegli Jatene
OBJECTIVE: To identify main complications in outpatient follow-up, as well as factors before or during operation that may interfere in patient's evolution. METHODS: Retrospective study of patients submitted to total cavopulmonary shunt with extracardiac conduit from 2000 to 2014 at the Hospital do Coração (São Paulo, Brazil) and who underwent clinical follow-up at this institution. RESULTS: One hundred and fifty surgeries were performed and 59 patients maintained outpatient follow-up...
May 2018: Brazilian Journal of Cardiovascular Surgery
Tae Kyoung Jo, Hyo Rim Suh, Bo Geum Choi, Jung Eun Kwon, Hanna Jung, Young Ok Lee, Joon Yong Cho, Yeo Hyang Kim
PURPOSE: The present study aimed to evaluate progression and prognosis according to the palliation method used in neonates and early infants aged 3 months or younger who were diagnosed with pulmonary atresia with ventricular septal defect (PA VSD) or tetralogy of Fallot (TOF) with severe pulmonary stenosis (PS) in a single tertiary hospital over a period of 12 years. METHODS: Twenty with PA VSD and 9 with TOF and severe PS needed initial palliation. Reintervention after initial palliation, complete repair, and progress were reviewed retrospectively...
July 2018: Korean Journal of Pediatrics
Dan Laukka, Riitta Rautio, Melissa Rahi, Jaakko Rinne
BACKGROUND: Flow diverter (FD) treatment of ruptured fusiform posterior cerebral artery (PCA), posterior inferior cerebellar artery (PICA), and superior cerebellar artery (SCA) aneurysms are limited to single reports. OBJECTIVE: To study the safety and efficacy of FD treatment for ruptured fusiform aneurysms of the PCA, SCA, and PICA. METHODS: Five patients with ruptured posterior circulation fusiform aneurysms and treated with a Flow-Redirection Endoluminal Device (FRED/FRED Jr; Microvention, Tustin, California) stent in the acute phase of subarachnoid hemorrhage between 2013 and 2016 were included and reviewed retrospectively...
July 19, 2018: Operative Neurosurgery (Hagerstown, Md.)
Michael C Dewan, Ronnie E Baticulon, Krishnan Ravindran, Christopher M Bonfield, Dan Poenaru, William Harkness
PURPOSE: Quantifying the global burden of pediatric neurosurgical disease-and current efforts addressing it-is challenging, particularly in the absence of uniform terminology. We sought to establish bellwether procedures for pediatric neurosurgery, in order to standardize terminology, establish priorities, and facilitate goal-oriented capacity building. METHODS: Members of international pediatric neurosurgical and pediatric surgical societies were surveyed via the Research Electronic Data Capture (REDCap) platform...
July 21, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Hieu Lan Nguyen, Quang Tan Phan, Linh Huynh Dinh, Hieu Ba Tran, Hoyoun Won, Julian Johny Thottian, Dung Doan Duc, Truong Nguyen Quang, Sang Wook Kim
OBJECTIVE: To evaluate the efficacy and safety of Nit-Occlud Lê VSD Coil versus Duct Occluders for percutaneous closure of perimembranous ventricular septal defect (pmVSD). INTRODUCTION: VSD closure using conventional pmVSD occluders has been largely abandoned because of an unacceptable high rate of complete heart block (CHB). The advantages of Duct Occluders and VSD Coil are supposed to reduce the drawbacks of previous devices, especially CHB complications. METHOD: Patients underwent percutaneous pmVSD closure were divided into Coil group (using VSD Coil, n = 71) and DO group (using Duct Occluders, n = 315)...
July 17, 2018: Congenital Heart Disease
SungHo Jang, HanDo Lee
OBJECTIVE:  To demonstrate the change of the ascending reticular activating system (ARAS) concurrent with the recovery of impaired consciousness following a shunt operation in a stroke patient. METHODS:  A 65-year-old female patient underwent coiling of a ruptured right posterior communicating artery and, subsequently, underwent right external ventricular drain (EVD) placement, left EVD placement, and lumbar drain placement for management of intraventricular hemorrhage...
July 16, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Ryan Gallagher, Jodie Marquez, Peter Osmotherly
BACKGROUND: Idiopathic normal pressure hydrocephalus (iNPH) is treated by insertion of a ventricular peritoneal (VP) shunt. To help identify who would benefit from a VP shunt, patients undergo a tap test (TT). Several measures can identify change from a TT, but the magnitude of change and the combination of measures that indicate the improvement from a TT is unclear. OBJECTIVE: To develop minimal clinically important differences (MCIDs) for a battery of gait, balance, and cognitive measures in relation to improvement from the TT, and to identify which combination of measures best identifies when improvement has occurred...
July 12, 2018: Neurosurgery
Seif Eid, Joe Iwanaga, Rod J Oskouian, Marios Loukas, W Jerry Oakes, R Shane Tubbs
INTRODUCTION: The subgaleal space is the fibroareolar layer found between the galea aponeurotica and the periosteum of the scalp. Due to its elastic and absorptive capabilities, the subgaleal space can be used as a shunt to drain excess cerebrospinal fluid from the ventricles. A subgaleal shunt consists of a shunt tube with one end in the lateral ventricles while the other end is inserted into the subgaleal space of the scalp. This will allow for the collection and absorption of excess cerebrospinal fluid...
July 12, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Gabriella S Lamb, Coralee Del Valle Mojica, Nivedita Srinivas, Jeffrey Starke
A 4-year-old former 24-week gestation male and an 18-month-old former 26-week gestation female, both with history of intraventricular hemorrhage resulting in hydrocephalus, presented with Mycobacterium abscessus ventricular shunt infections affecting both the shunt track and the ventricular fluid. Both children required prolonged combination antimycobacterial therapy; the 4 year old required more than two months of triple intravenous antibiotics and intraventricular amikacin to sterilize the cerebrospinal fluid...
July 11, 2018: Pediatric Infectious Disease Journal
C Gaderer, A Schaumann, M Schulz, U W Thomale
OBJECTIVE: The treatment of infectious CSF condition with ventriculitis and hydrocephalus in children is an interdisciplinary challenge. Conventional surgical treatment includes external ventricular drain (EVD) and systemic antibiotic therapy. However, infectious contamination of large ventricles combined with CSF protein overload often requires long treatment regimens. We retrospectively investigated neuroendoscopic lavage as a new option for clearance of CSF in children with hydrocephalus and active CSF infection...
July 11, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Abhay Sane, Kevin Tangen, David Frim, Meenesh R Singh, Andreas A Linninger
OBJECTIVE: Proximal obstruction due to cellular material is a major cause of shunt failure in hydrocephalus management. The standard approach to treat such cases involves surgical intervention which unfortunately is accompanied by inherent surgical risks and a likelihood of future malfunction. We report a prototype design of a proximal ventricular catheter capable of non-invasively clearing cellular obstruction. METHODS: In vitro cell-culture methods show that low-intensity AC signals successfully destroyed a cellular layer in a localized manner by means of Joule heating induced hyperthermia...
February 5, 2018: IEEE Transactions on Bio-medical Engineering
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