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Shunt infection

Lukas Grassner, Franz Marhold, Yousif Miron, Andreas Grillhösl, Karl Ungersboeck, Joachim Schulz, Martin Strowitzki
BACKGROUND: Decompressive craniectomy is a commonly performed procedure. It reduces intracranial pressure, improves survival, and thus might have a positive impact on several neurosurgical diseases and emergencies. Sometimes primary skin closure is not possible due to cerebral herniation or extensive skin defects. In order to prevent further restriction of the underlying tissue, a temporary skin expansion might be necessary. METHODS AND MATERIAL: We retrospectively reviewed patients in need for a temporary skin substitute because skin closure was not possible after craniectomy without violating brain tissue underneath in a time period of 6 years (2011-2016)...
December 4, 2018: Acta Neurochirurgica
Amr Ali Hasanain, Ahmed Abdullah, Mohamed F M Alsawy, Mohamed A R Soliman, Ammar Ali Ghaleb, Reem Elwy, Ahmed A M Ezzat, Ahmed Al Menabbawy, Ahmed A Marei, Bassante Abd El Razik, Mostafa I El Hamaky, Henry W S Schroeder, Steffen Fleck, Ahmed El Damaty, Sascha Marx, Stephan Nowak, Jörg Baldauf, Ahmed Zohdi, Ehab Ahmed El Refaee
OBJECTIVES:  Ventriculoperitoneal (VP) shunting is commonly used to treat pediatric hydrocephalus, but failure rates are high. VP shunt failure in children is mostly caused by infection and/or proximal/distal shunt obstruction. However, to our knowledge, no previous reviews have discussed this topic using only clinical studies when age-related data could be obtained. This systematic review aimed at reevaluating what is already known as the most common causes of shunt failure and to determine the incidence and causes of VP shunt failure during the first 2 years of life as a step to establish solid evidence-based guidelines to avoid VP shunt failure in infants...
December 3, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Koneru Lakshmi Umamaheshwar, Arvind Sahadev Singh, Kothandam Sivakumar
Fontan surgery and its modifications have improved survival in various forms of univentricular hearts. A regular atrial rhythm with atrioventricular synchrony is one of the most important prerequisite for the long-term effective functioning of this preload dependent circulation. A significant proportion of these survivors need various forms of pacing for bradyarrhythmias, often due to sinus nodal dysfunction and sometimes due to atrioventricular nodal block. The diversion of the venous flows away from the cardiac chambers following this surgery takes away the simpler endocardial pacing options through the superior vena cava...
November 30, 2018: Indian Pacing and Electrophysiology Journal
Ann Alriksson-Schmidt, Annika Lundkvist Josenby, Barbro Lindquist, Lena Westbom
PURPOSE: To increase knowledge about pain and general health in adults with myelomeningocele, a health condition with several risk factors for pain such as musculoskeletal deformities, shunt dysfunctions, bowel problems, and urinary tract infections/stones. METHODS: Descriptive correlational pilot study (N= 51, 53% males). Chi-square tests were used to test associations among presence, impact, severity, and pain site in relation to sex and age. ANOVA was used to analyze associations between sex, age, and general health (today)...
November 18, 2018: Journal of Pediatric Rehabilitation Medicine
(no author information available yet)
OBJECTIVEGastrostomy tube placement can temporarily seed the peritoneal cavity with bacteria and thus theoretically increases the risk of shunt infection when the two procedures are performed contemporaneously. The authors hypothesized that gastrostomy tube placement would not increase the risk of ventriculoperitoneal shunt infection. The object of this study was to test this hypothesis by utilizing a large patient cohort combined from multiple institutions.METHODSA retrospective study of all adult patients admitted to five institutions with a diagnosis of aneurysmal subarachnoid hemorrhage between January 2005 and January 2015 was performed...
November 1, 2018: Journal of Neurosurgery
(no author information available yet)
OBJECTIVEDifferent CSF diversion procedures (ventriculoperitoneal, ventriculoatrial, and lumboperitoneal shunting) have been utilized for the treatment of idiopathic normal pressure hydrocephalus. More recently, endoscopic third ventriculostomy has been suggested as a reasonable alternative in some studies. The purpose of this study was to perform a systematic review and meta-analysis to assess overall rates of favorable outcomes and adverse events for each of these treatments. An additional objective was to determine the outcomes and complication rates in relation to the type of valve utilized (fixed vs programmable)...
November 1, 2018: Journal of Neurosurgery
(no author information available yet)
OBJECTIVEHydrocephalus with a blocked ventriculoperitoneal (VP) shunt is a life-threatening condition. Emergency endoscopic third ventriculostomy (ETV) is a potential treatment option. The aim of the study was to identify independent risk factors associated with failure of ETV in treating patients with blocked shunts.METHODSThe authors retrospectively reviewed data from consecutive patients admitted for blocked shunt treated by ETV during the study period from 2000 to 2016. Univariate and multivariate analyses were performed to identify independent factors associated with failed ETV for blocked shunts, such as age, sex, history of CNS infection, number of previous shunt revisions, operations performed as an emergency or elective, number of specialists, and other factors...
November 1, 2018: Journal of Neurosurgery
(no author information available yet)
Ventriculoperitoneal (VP) shunt infections are seen in 3%-17% of patients with VP shunts. These infections may cause severe morbidity and mortality. Staphylococci are the most common cause of CSF shunt-associated infections, although gram-negative bacteria (especially multidrug-resistant [MDR] and extensive drug-resistant [XDR] bacteria) also play an important role. Due to increased antibiotic resistance, sometimes off-label usage of antibiotics is considered. Tigecycline is one of these antibiotics. It should not be used unless there are no other antibiotic treatment options available, especially in children...
November 1, 2018: Journal of Neurosurgery. Pediatrics
Nikoloz Koshkelashvili, Priya Kohli, Jason Linefsky
CLINICAL INTRODUCTION: A 57-year-old man from the USA with a history of atrial fibrillation and hypertension was evaluated for progressive dyspnoea and decreased energy. The patient denied a history of congestive heart failure, systemic symptoms or myocardial infarction. He was found to have a 3/6 holosystolic murmur radiating to the axilla. Transthoracic echocardiography (TTE) reported a reduced ejection fraction of 40%, mitral valve regurgitation and absence of interatrial shunts. The remaining cardiac valves were without abnormality...
November 22, 2018: Heart: Official Journal of the British Cardiac Society
Ruth Link-Gelles, Karrie-Ann Toews, William Schaffner, Kathryn M Edwards, Carolyn Wright, Bernard Beall, Brenda Barnes, Brenda Jewell, Lee H Harrison, Pam D Kirley, Lauren Lorentzson, Deborah Aragon, Susan Petit, Joseph Bareta, Nancy L Spina, Paul R Cieslak, Chris Van Beneden
Background: Few data on intracranial group A Streptococcus (GAS) infection in children are available. Here, we describe the demographic, clinical, and diagnostic characteristics of 91 children with intracranial GAS infection. Methods: Cases of intracranial GAS infection in persons ≤18 years of age reported between 1997 and 2014 were identified by the Centers for Disease Control and Prevention's population- and laboratory-based Active Bacterial Core surveillance (ABCs) system...
November 21, 2018: Journal of the Pediatric Infectious Diseases Society
Mostafa Osman, Ahmed Diraz
Arachnoid cyst can be defined as cerebral-spinal fluid entrapment within the central nervous system. It may occur primarily as a congenital malformation or secondary as a complication following trauma, infection, bleeding, or surgical manipulation. Congenital arachnoid cyst usually asymptomatic and cause no pressure symptoms. No treatment is needed unless size increase and cause pressure symptoms and increased intracranial pressure. We report a case presented to the hospital with neurological signs of increased intracranial pressure, 3 years Post aborted craniotomy for meningioma resection...
October 2018: Asian Journal of Neurosurgery
Mohammad Mahfuzur Rahman, Mohammad Abdus Salam, Kalim Uddin, Mohammad Mizanur Rahman, Mohammad Rafiqul Islam, Mohammad Ashraful Haque, Ahmed Riyad Hussain, Mohammad Abdullah Yusuf
Background: Management of obstructive hydrocephalus is an important issue for the reduction of mortality and morbidity. Objectives: The aim of the present study was to assess the early surgical outcome of endoscopic third ventriculostomy (ETV) in the management of obstructive hydrocephalus. Methodology: This randomized controlled trial was conducted at the Department of Neurosurgery at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from April 2009 to September 2010 for 1½ years...
October 2018: Asian Journal of Neurosurgery
Brigitta Balogh, Tamás Kovács, Amulya Kumar Saxena
INTRODUCTION: The aim of this study was to analyze the complication rates and mortality in association with different operative techniques of percutaneous endoscopic gastrostomy (PEG), age, underlying diseases and other risk factors. Moreover, analysis of the indications of PEG insertion and the underlying comorbidities was also performed. METHODS: This study performs a literature analysis of PEG-related complications in children. Literature was searched on PubMed® (1994-2017) using terms "percutaneous endoscopic gastrostomy", "complications", "mortality" and "children"...
November 19, 2018: World Journal of Pediatrics: WJP
Prenali Dwisthi Sattwika, Anggoro Budi Hartopo, Dyah Wulan Anggrahini, Hasanah Mumpuni, Lucia Kris Dinarti
Uncorrected left-to-right shunt congenital heart defect is a predisposing factor for infective endocarditis (IE), especially right-sided IE which has different clinical manifestations and complications from left-sided IE. Prompt diagnosis by means of transthoracic echocardiography and timely antibiotics management for IE are encouraged to prevent multiorgan failure and fatal pulmonary embolism.
November 2018: Clinical Case Reports
Elizabeth A K Hunt, Michael J G Somers
Acute postinfectious glomerulonephritis or infection-related glomerulonephritis has been associated with several viral or bacterial infections. Group A beta-hemolytic streptococcal infection is the prototypical cause of postinfectious glomerulonephritis and the main focus of this discussion. The clinical spectrum can vary widely, from asymptomatic microscopic hematuria incidentally detected on routine urinalysis to rapidly progressive glomerulonephritis with acute kidney injury requiring emergent dialysis. Other important causes include glomerulonephritis associated with endocarditis and ventriculoatrial shunt infections...
February 2019: Pediatric Clinics of North America
M Dedeciusová, T Tyll, V Beneš, D Netuka
Subdural empyema is a rare purulent intracranial infection. Outcome is dependent on the preoperative level of consciousness, therefore an early diagnosis and urgent neurosurgical intervention are necessary. Mortality of subdural empyema remains high, ranging from 6% to 15%. The case report presents a patient with subdural empyema which resulted from sinusitis. The integral and first part of therapy was an urgent neurosurgical drainage of subdural empyema, followed by functional endoscopic sinus surgery performed by ENT surgeon...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
John G Webster, Bermans Iskandar, Joshua Medow, Christopher Luzzio, Xuan Zhang, Chenxiao Guan, Zhe Yang
Hydrocephalus is a neurological condition that can result from trauma, hemorrhage, cancer, and infection. To control the intracranial pressure (ICP) a shunt is implanted to drain the cerebro-spinal fluid (CSF). We are working to develop an implantable pressure sensor. When the ICP is too high it will open a valve to relieve the ICP. When the ICP is too low, it will close the valve.
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
S Sun, H Zhou, Z-Z Ding, H Shi
BACKGROUND AND AIM: Post-traumatic hydrocephalus is a common complication that arises after head injury. However, risk factors associated with the outcome of post-traumatic hydrocephalus have seldom been addressed. Therefore, we performed this clinical study to analyze the risk factors affecting the outcome of post-traumatic hydrocephalus in patients with head injuries. METHODS: A total of 116 post-traumatic hydrocephalus patients, admitted in our hospital between March 2012 and October 2017 were reviewed...
November 14, 2018: Scandinavian Journal of Surgery: SJS
Rishabh Agarwal, Amanda Allen, Lauren Green
Ventriculoperitoneal (VP) shunts complications are most often divided into 2 broad categories: mechanical failure and infection. We report a case of a migrated VP shunt with subsequent development of a pseudocyst around the patient's breast implant, a rare complication. We review the literature of VP shunt complications, including the increasing number of reported breast-related complications, and discuss proposed mechanisms by which migration may occur. With the increase in patients with breast augmentation procedures, there is potential for an increase in the number of reported cases of VP shunt migration...
February 2019: Radiology Case Reports
Amos Lal, Jamal Akhtar, Ashfaq Ullah, George M Abraham
Staphylococcus simulans is a coagulase-negative organism, mainly an animal pathogen. Reports of human infection have been infrequent, mainly in patients with repeated animal contact. We report the first case of pleural empyema in an elderly woman. S. simulans tends to cause more severe infection because of a biofilm layer which helps in adherence and colonization of smooth surfaces, especially prosthetic devices, shunts, and catheters. The challenging problem even after CoNS isolation and identification is the assessment of their clinical relevance...
2018: Case Reports in Infectious Diseases
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