Ventriculostomy with subsequent ventriculoperitoneal shunt placement after subarachnoid hemorrhage: the effect of implantation site on postoperative complications—a single-center series

2020 ◽  
Vol 162 (8) ◽  
pp. 1831-1836 ◽  
Author(s):  
Inja Ilic ◽  
Patrick Schuss ◽  
Valeri Borger ◽  
Alexis Hadjiathanasiou ◽  
Hartmut Vatter ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Postoperative Complications ◽  
Ventriculoperitoneal Shunt ◽  
Implantation Site ◽  
Single Center ◽  
Shunt Placement

Role of Fever in Ventriculoperitoneal Shunt Placement After Aneurysmal Subarachnoid Hemorrhage

Neurosurgery ◽  
2011 ◽  
Vol 70 (6) ◽  
pp. 1361-1368 ◽  
Author(s):  
Robert M. Starke ◽  
Ricardo J. Komotar ◽  
Brian Y. Hwang ◽  
Fred Rincon ◽  
Ivan S. Kotchetkov ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Ventriculoperitoneal Shunt ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Shunt Failure ◽  
Persistent Fever ◽  
Shunt Placement ◽  
Patient Demographics ◽  
Increased Risk

Abstract BACKGROUND: Central fever is common after aneurysmal subarachnoid hemorrhage (aSAH) and may delay ventriculoperitoneal shunt (VPS) placement. OBJECTIVE: We hypothesize that drain-dependent aSAH patients with central fever or persistent fever after treatment of an identifiable cause are not at an increased risk of infectious VPS failure. METHODS: Patient demographics, radiographic characteristics, temperature, incidence of infection, and shunt failure were prospectively recorded in a consecutive cohort of aSAH patients. Central fever was defined as temperature higher than 38.3°C with no identifiable cause. RESULTS: Of 580 patients, 61 (11%) were drain dependent. Central fever developed in 18, 35 had fever of known etiology, and 8 remained afebrile. There was no shunt failure at discharge, and 2 failures (3.2%) at follow-up were attributed to infection. One patient with central fever (6%), none with fever of identifiable etiology, and 1 (13%) with no fever had infectious shunt failures at a median follow-up of 10.2 ± 3.6 months (P > .05). Nine patients with central fever (50%) and 6 (17%) who were treated for fever of known etiologies had persistent fever at shunt placement. Patients who were febrile on the day of surgery had similar infectious shunt failure rates at discharge compared with those who were afebrile (0% vs 0%; P = 1.0). Similarly, febrile and afebrile patients at VPS insertion had comparable rates of infectious shunt failure at follow-up (7% vs 2%; P = .43). CONCLUSION: aSAH patients with central fever or persistent fever after treatment of fever of identifiable etiology are not at an increased risk of infectious VPS failure.

scholarly journals Effects of post-interventional antiplatelet therapy on angiographic vasospasm, delayed cerebral ischemia, and clinical outcome after aneurysmal subarachnoid hemorrhage: a single-center experience

2021 ◽  
Author(s):  
Claudia Ditz ◽  
Björn Machner ◽  
Hannes Schacht ◽  
Alexander Neumann ◽  
Peter Schramm ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Ischemia ◽  
Functional Outcome ◽  
Antiplatelet Therapy ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Delayed Cerebral Ischemia ◽  
Control Group ◽  
Lesion Volume ◽  
Single Center ◽  
Single Center Experience

AbstractPlatelet activation has been postulated to be involved in the pathogenesis of delayed cerebral ischemia (DCI) and cerebral vasospasm (CVS) after aneurysmal subarachnoid hemorrhage (aSAH). The aim of this study was to investigate potentially beneficial effects of antiplatelet therapy (APT) on angiographic CVS, DCI-related infarction and functional outcome in endovascularly treated aSAH patients. Retrospective single-center analysis of aSAH patients treated by endovascular aneurysm obliteration. Based on the post-interventional medical regime, patients were assigned to either an APT group or a control group not receiving APT. A subgroup analysis separately investigated those APT patients with aspirin monotherapy (MAPT) and those receiving dual treatment (aspirin plus clopidogrel, DAPT). Clinical and radiological characteristics were compared between groups. Possible predictors for angiographic CVS, DCI-related infarction, and an unfavorable functional outcome (modified Rankin scale ≥ 3) were analyzed. Of 160 patients, 85 (53%) had received APT (n = 29 MAPT, n = 56 DAPT). APT was independently associated with a lower incidence of an unfavorable functional outcome (OR 0.40 [0.19–0.87], P = 0.021) after 3 months. APT did not reduce the incidence of angiographic CVS or DCI-related infarction. The pattern of angiographic CVS or DCI-related infarction as well as the rate of intracranial hemorrhage did not differ between groups. However, the lesion volume of DCI-related infarctions was significantly reduced in the DAPT subgroup (P = 0.011). Post-interventional APT in endovascularly treated aSAH patients is associated with better functional outcome at 3 months. The beneficial effect of APT might be mediated by reduction of the size of DCI-related infarctions.

First Reported Case of Postneurosurgical Ventriculoperitonitis Due to Kocuria rhizophila Following a Ventriculoperitoneal Shunt Placement

2020 ◽  
Vol 28 (3) ◽  
pp. 169-170
Author(s):  
Vincent Mathy ◽  
Benjamin Chousterman ◽  
Anne-Lise Munier ◽  
Emmanuelle Cambau ◽  
Hervé Jacquier ◽  
...  
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Shunt Placement ◽  
Kocuria Rhizophila

Transumbilical approach for ventriculoperitoneal shunt placement in infants and small children: a 6-year experience

2011 ◽  
Vol 28 (2) ◽  
pp. 217-219 ◽  
Author(s):  
R. Shane Tubbs ◽  
Lilian C. Azih ◽  
Martin M. Mortazavi ◽  
Joshua J. Chern ◽  
Todd Hankinson ◽  
...  
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Small Children ◽  
Shunt Placement
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