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overdrainage of ventricular shunting

Laura V Sainz, Konstantin Hockel, Martin U Schuhmann
INTRODUCTION: Chronic overdrainage affects shunted patients producing a variety of symptoms that may be misdiagnosed. The best known symptoms are so-called shunt-related headaches. There is mounting evidence that changes in cerebrospinal venous system dynamics are a key factor to the pathophysiology of chronic overdrainage syndrome. CLINICAL PRESENTATION: We report the case of a 29-year-old woman with a shunt since the postnatal period suffering from chronic but the most severe intermittent headache attacks, despite an open shunt and with unchanged ventricular width during attacks...
November 11, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Mark R Kraemer, Carolina Sandoval-Garcia, Taryn Bragg, Bermans J Iskandar
OBJECTIVE The authors conducted a survey to evaluate differences in the understanding and management of shunt-dependent hydrocephalus among members of the American Society of Pediatric Neurosurgeons (ASPN). METHODS Surveys were sent to all 204 active ASPN members in September 2014. One hundred thirty responses were received, representing a 64% response rate. Respondents were asked 13 multiple-choice and free-response questions regarding 4 fundamental problems encountered in shunted-hydrocephalus management: shunt malfunction, chronic cerebrospinal fluid (CSF) overdrainage, chronic headaches, and slit ventricle syndrome (SVS)...
September 2017: Journal of Neurosurgery. Pediatrics
S Alavi, M Schulz, A Schaumann, K Schwarz, Ulrich W Thomale
OBJECTIVE: Overdrainage in children is a long-term problem for shunted patients which might lead to chronic anatomical changes. In order to prevent these problems, valve exchange is performed on a regular basis in patients without hydrostatic units towards a valve with both an adjustable and a gravitational unit. The clinical outcome of these patients is reported in a retrospective study. METHODS: Between 2009 and 2014, the in-house database was analyzed for patients who received a valve exchange towards an adjustable differential pressure valve with gravitational unit...
May 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Tianyuan Zhao, Wei Ouyang, Shaobing Wang, Peitao Wu
BACKGROUND: Shunting to the cranial venous sinus represents a novel treatment strategy for hydrocephalus. To our knowledge, overdrainage as a complication after shunting to the cranial venous sinus has not previously been reported in the clinical literature. Here we report the case of a 50-year-old man who suffered from overdrainage after a ventriculosinus shunt insertion. CASE DESCRIPTION: A 50-year-old man was admitted to our hospital with recurring fever and gait difficulty 4 months after a ventriculoperitoneal shunt (VPS) insertion for primary communicating hydrocephalus...
June 2017: World Neurosurgery
Boby Varkey Maramattom, Dilip Panikar
A trapped fourth ventricle often requires fourth ventriculoperitoneal shunting (4VP). Complications of this procedure include shunt blockage, infection, shunt migration, and overdrainage. Cranial nerve palsies are very rare after 4VP shunting and have been described with over drainage and brainstem distortion. We present an unusual case of bilateral abducens and facial nerve palsies after 4VP shunting after normalization of 4(th) ventricular parameters. Measurement of various brainstem angles presented us with a plausible hypothesis to explain the cranial nerve dysfunction...
October 2016: Annals of Indian Academy of Neurology
Su-Ho Kim, Yoon-Soo Lee, Min-Seok Lee, Sang-Jun Suh, Jeong-Ho Lee, Dong-Gee Kang
Although the Codman-Hakim programmable valve is one of most popular shunt systems used in the clinical practice for the treatment of hydrocephalus, malfunctions related with this system have been also reported which lead to underdrainage or overdrainage of the cerebrospinal fluid. While obstruction of the ventricular catheter by tissue materials or hematoma and catheter disconnection are relatively common, the malfunction of the valve itself is rare. Herein, we report on a rare case of shunt overdrainage caused by displacement of the pressure control cam after pressure adjustment...
October 2016: Korean Journal of Neurotrauma
Yuichi Nagata, Kazuhito Takeuchi, Mihoko Kato, Hirokatsu Osawa, Tadashi Watanabe, Toshihiko Wakabayashi
Slit-ventricle syndrome (SVS) seems to encompass various pathophysiological abnormalities, including overdrainage of cerebrospinal fluid (CSF) and craniocerebral disproportion after extracranial CSF shunt placement. These pathologies result in small ventricle morphologically, and the ventricular catheter is obstructed by the collapsed ventricular walls. Patients with intermittent headaches, small ventricles on neuroimaging, and slow refill of the shunt reservoir are diagnosed with SVS. In this report, we present a case of SVS treated endoscopically...
November 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Vijetha V Maller, Amit Agarwal, Sangam Kanekar
A cerebrospinal fluid (CSF) shunt is an internalized system used for the treatment of hydrocephalus and connects the ventricular system to the peritoneal space, right atrium, or the pleural space. The CSF shunt malfunction can occur due to obstruction, migration, overdrainage, infection, or CSF accumulation at the distal end. Although conventional radiography and radionuclide studies are used for evaluation of integrity of the shunts, computed tomography, ultrasound, and magnetic resonance imaging are used for the evaluation of shunt obstruction, migration, CSF accumulations, infections, overdrainage, and other complications...
April 2016: Seminars in Ultrasound, CT, and MR
Renan M Pereira, Mariane T Suguimoto, Matheus F Oliveira, Juliana B Tornai, Ricardo A Amaral, Manoel Jacobsen Teixeira, Fernando Campos Gomes Pinto
Normal pressure hydrocephalus (NPH) is characterized by the triad of gait apraxia, dementia and urinary incontinence associated with ventriculomegaly and normal pressure of cerebrospinal fluid. Treatment is accomplished through the implantation of a ventricular shunt (VPS), however some complications are still frequent, like overdrainage due to siphon effect. This study analyses the performance of a valve with anti-siphon device (SPHERA®) in the treatment of patients with NPH and compares it with another group of patients with NPH who underwent the same procedure without anti-siphon mechanism (PS Medical® valve)...
January 2016: Arquivos de Neuro-psiquiatria
Manabu Niimura, Keisuke Takai, Makoto Taniguchi
We report two cases with postoperative epidural haematomas (EDHs) associated with hydrocephalus and discuss the cause of haematoma development on the basis of a literature review. A 13-year-old boy presented with obstructive hydrocephalus caused by a sellar mass lesion. Multifocal EDHs occurred after partial resection of the lesion via a transcallosal approach following ventricular drainage. In the second case, a 26-year-old man who had a history of ventriculoperitoneal shunting for congenital hydrocephalus presented with hydrocephalus caused by ventricular catheter obstruction...
February 9, 2015: BMJ Case Reports
José M Santín-Amo, María Rico-Cotelo, Ramón Serramito-García, Miguel Gelabert-González, Alfredo G Allut
INTRODUCTION: The surgical treatment of hydrocephalus is one of the most commonly procedures of modern pediatric neurosurgical practice, and cerebrospinal fluid shunts are the main means of treatment of hydrocephalus, being independent of site of obstruction and ventricular shunt complications are frequent, especially in children. The most common complications are shunt obstructions, mechanical disconnections, overdrainage and infection. CASE REPORT: A 7.5-year-old girl with ventriculoperitoneal shunt presented with intermittent headache...
March 16, 2014: Revista de Neurologia
Adam N Wallace, Jonathan McConathy, Christine O Menias, Sanjeev Bhalla, Franz J Wippold
OBJECTIVE: The objective of this article is to describe an approach to imaging CSF shunts. Topics reviewed include the components and imaging appearances of the most common types of shunts and the utility of different imaging modalities for the evaluation of shunt failure. Complications discussed include mechanical failure, infection, ventricular loculation, overdrainage, and unique complications related to each shunt type. CONCLUSION: This article reviews the imaging features of common CSF shunts and related complications with which radiologists should be familiar...
January 2014: AJR. American Journal of Roentgenology
Grant A Bateman
Symptomatic shunt malfunction without ventricular enlargement is known as slit ventricle syndrome (SVS). Patients presenting with this syndrome are not a homogeneous group. Of the 5 different types classified by Rekate, Type 1 is caused by CSF overdrainage and is associated with low pressures; Types 2 and 3 are associated with shunt blockage and elevated CSF pressures; Type 4 is cephalocranial disproportion that increases brain parenchymal pressure but not CSF pressure; and Type 5 is headache unrelated to shunt function...
December 2013: Journal of Neurosurgery
Fernando Campos Gomes Pinto, Renan Muralho Pereira, Felippe Saad, Manoel Jacobsen Teixeira
Patients with hydrocephalus and risk factors for overdrainage may be submitted to ventricular shunt (VS) implant with antisiphon device. The objective of this study was to prospectively evaluate for two years the clinical and tomographic results of the implant of fixed-pressure valves with antisiphon device SPHERA(®) in 35 adult patients, with hydrocephalus and risk factors for overdrainage. Of these, 3 had congenital hydrocephalus in adult patients with very dilated ventricles (Evans index >50%), 3 had symptomatic overdrainage after previous VS implant (subdural hematoma, hygroma or slit ventricle syndrome), 1 had previous chronic subdural hematoma, 15 had normal pressure hydrocephalus with final lumbar pressure <5 cm H(2)O after tap test (40 mL), 6 had pseudotumor cerebri, and 7 had hydrocephalus due to other causes...
September 2012: Arquivos de Neuro-psiquiatria
M Kiefer
CLINICAL/METHODICAL ISSUE: Modern treatment of hydrocephalus. STANDARDS OF CLINICAL AND RADIOLOGICAL METHODS: Clinically: shunting and endoscopy. Radiologically: MRT, CCT. METHODICAL INNOVATIONS: Important innovations are gravitational valves and neuroendoscopy standing for new challenges in preoperative imaging and for sufficient interpretation of postoperative imaging. PERFORMANCE: G-valves reduce the complication rate (especially overdrainage) in shunting significantly...
September 2012: Der Radiologe
Victoria T Trinh, Edward A M Duckworth
INTRODUCTION: High intracranial compliance states requiring negative pressure drainage, otherwise known as low-pressure hydrocephalus syndromes, are rare conditions. The use of siphoning, enabled by revision to an adjustable shunt without an anti-siphon device, has been largely unexplored in low-pressure hydrocephalus. METHODS: Three patients with presumed normal pressure hydrocephalus (NPH) presented with unresolved symptoms, including urinary incontinence, disturbed gait, and cognitive dysfunction...
February 2013: Clinical Neurology and Neurosurgery
Uwe Kehler, Niels Langer, Jan Gliemroth, Ullrich Meier, Johannes Lemcke, Christian Sprung, Hans-Georg Schlosser, Michael Kiefer, Regina Eymann, Oliver Heese
OBJECTIVE: Shunt obstructions may partly be caused by brain debris, which intrude into the ventricular catheter during ventricle puncture. Avoiding contact between the catheter and brain tissue, by using a peel-away sheath, should reduce the number of shunt failures caused by obstruction. To test this hypothesis, we conducted a randomized, prospective multicenter study. METHODS: 201 patients from 6 different neurosurgical centers in Germany receiving a ventriculo-peritoneal shunt were included in this study...
May 2012: Clinical Neurology and Neurosurgery
Michael Moses, Adrianna Ranger, Arjang Yazdani
Slit-ventricle syndrome (SVS) is characterized by headaches associated with subnormal ventricular size in patients with shunt-treated hydrocephalus. It commonly occurs in children who have had shunts placed at an early age and is diagnosed when computed tomography scans are carried out to investigate suspected shunt obstruction with an accompanying rise in intracranial pressure (ICP). Overdrainage of cerebrospinal fluid may additionally result in craniocephalic disproportion, potentially by dampening the normal expansile pulsations of the dura against the skull, which leads to craniostenosis...
November 2011: Journal of Craniofacial Surgery
Wajd N Al-Holou, Jayson A Sack, Hugh J L Garton, Karin M Muraszko, Cormac O Maher
BACKGROUND: Although most patients with an implanted ventriculoperitoneal shunt device will require cerebrospinal fluid diversion over the course of their lifetime, there appears to be a small number of patients that are shunt independent and may benefit from shunt removal. METHODS: We retrospectively analyzed 661 patients with hydrocephalus treated over a 10-year period at a single institution. In 10 patients, a systematic shunt weaning protocol was attempted before removal of the cerebrospinal fluid shunt...
2010: Pediatric Neurosurgery
Morteza Faghih Jouibari, Nazanin Baradaran, Rouzbeh Shams Amiri, Farideh Nejat, Mostafa El Khashab
OBJECTIVE: Lack of comprehensive knowledge and numerous socioeconomic problems may make the parents leave hydrocephalic children untreated, leading to progressive hydrocephalus and eventual unordinary big head. Management of huge hydrocephalus (HH) differs from common hydrocephalus. We present our experience in the management of these children. METHODS: HH is defined as head circumference larger than the height of the infant. Nine infants with HH have been shunted in Children's Hospital Medical Center and followed up for 0...
January 2011: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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