Search results for "Ventriculoperitoneal Shunt"

The Quest for Predictors of Shunt-Dependent Chronic Hydrocephalus After Aneurysmal Subarachnoid Hemorrhage: Toward a Tailored Approach for Permanent …

2021

PROSAIKA: A prospective multicenter registry with the first programmable gravitational device for hydrocephalus shunting

2015

Abstract Objective Cerebrospinal fluid (CSF) overdrainage is a major problem in shunt therapy for hydrocephalus. The adjustable gravitational valve proSA allows for the first time a targeted compensation for overdrainage in the upright position without interfering with the differential pressure valve. To evaluate benefit, safety and reliability, the multicenter prospective registry PROSAIKA was conducted in 10 German neurosurgical centers. Methods Between March 2009 and July 2010, 120 hydrocephalic patients undergoing first time shunt implantation or shunt revision using proSA entered the study. 93 patients completed the 12 months follow-up. Results Hydrocephalus symptoms were improved in 8…

Cerebrospinal Fluid Dynamics Following Ventriculoperitoneal Shunt in Hydrocephalus: Do Technological Advancements Avoid Complications?

2022

Intraoperative monitoring of cerebral blood flow during ventricular shunting in hydrocephalic pediatric patients.

1995

Several studies have demonstrated lowered cerebral blood flow (CBF) in patients with hydrocephalus and symptoms of raised intracranial pressure. Ventricular shunting in such cases permits a sudden increase in CBF. The pathophysiology of functional brain deficit secondary to hydrocephalus is little understood. Improvement of the patient's clinical status after drainage of CSF suggests that cerebral dysfunction is not necessarily due to permanent brain damage. In fact, it improves rapidly after ventricular taps. In view of this it would be helpful to monitor cerebral perfusion. The transcranial Doppler (TCD) ultrasonography technique allows real-time monitoring of the intracranial circulation…

CSF shunt infections in children

1993

The incidence of shunt infections and possible risk factors was investigated by chart analysis. From 1986 to 1989 350 shunt procedures were performed including 273 ventriculoperitoneal shunts and 75 ventriculoatrial shunts. Twenty-eight infectious episodes (8%) occurred in 25 patients during a median follow-up time of 20 months. For 204 patients the follow-up time could be prolonged until September 1992. In these patients no infectious episodes occurred in the extended observation period. In 24 cases (85.7%) a causative organism could be isolated. The infecting organisms were gram-positive cocci in 22 cases (78.6%) and gram-negative bacilli in two cases. The main signs and symptoms were fev…

Long-Term Efficacy of Shunt Therapy in Idiopathic Normal Pressure Hydrocephalus.

2019

Background: Idiopathic normal pressure hydrocephalus (iNPH) is one of the very few treatable types of dementia. Shunt therapy has been shown to be effective in improving symptoms. However, the long-term results of cerebrospinal fluid diversion are variable. The aim of this retrospective study was to investigate long-term outcomes of patients with idiopathic normal pressure hydrocephalus treated with ventriculoperitoneal shunt by using programmable valves. Methods: Symptoms before treatment were recorded. Clinical symptoms and outcome after ventriculoperitoneal shunt were assessed based on changes in gait, urinary incontinence, and cognitive dysfunction at yearly follow-up spanning at least …

The subway tunneling technique for distal shunt catheter insertion.

2019

Dear Editor,We read with interest the article by Osman et al. titled ‘Trocar assisted distal shunt tube insertion with intra-operative X-Ray confirmation’. The authors purpose their technique to pl...

A survey on current practice in the neurosurgical management of preterm infants with posthemorrhagic hydrocephalus in Germany.

2012

Background and Study Aims  Different approaches to the management of preterm infants with posthemorrhagic hydrocephalus (PHH) are described in the literature. Likewise, neurosurgical and pediatric surgical departments in German hospitals use different methods to treat these patients. The aim of this study was therefore to assess the current situation regarding the management of PHH, which is a first and essential step toward the development of standards of practice. Patients and Methods  In the second half of 2009, we sent standardized questionnaires to 139 neurosurgical departments (number of returned questionnaires: 98) and 73 pediatric surgical departments (returned questionnaires: 62) t…

Imaging of Ventriculoperitoneal Shunt Complications: Comparison of Whole Body Low-Dose Computed Tomography and Radiographic Shunt Series.

2016

OBJECTIVE To determine diagnostic value and radiation exposure of low-dose computed tomography (LD-CT) compared to radiographic shunt series (SS) for the detection of ventriculoperitoneal (VP) shunt complications. METHODS Fourteen VP shunts were implanted in 7 swine cadavers. Mechanical complications were induced in 50% of VP shunts. Low-dose CT (80 kVp, 10 mAs, Pitch = 1.5) and SS were acquired. Dose area product (DAP) and effective doses for SS and LD-CT were collected. Scoring of diagnostic confidence and blinded readings of SS and CT data were performed. RESULTS The sensitivity of LD-CT was high (0.97; 95% confidence interval, 0.91-1.00) with excellent interobserver agreement (κ = 0.88)…

Peripheral facial palsy following ventriculoperitoneal shunt. The lesson we have learned

2018

The most frequent complications after shunt surgery are infective and obstructive. Other types are less common, and eventually occur due to technical errors during brain ventricular puncture, opening the intraperitoneal cavity or the tunnelling of the catheter between the two points. Although rare, there are well-reported complications related to the poor positioning of the distal catheter, with perforation of organs and tissues.We report a very rare case of a male patient with normal pressure hydrocephalus submitted to ventriculoperitoneal shunt. During tunnelling of the shunt stylet, a peripheral facial palsy due to injury to the extra cranial segment of the facial nerve occurred.To the b…