scholarly journals P.127 Single centre review of lumboperitoneal shunt outcomes

2018 ◽  
Vol 45 (s2) ◽  
pp. S49-S49
Author(s):  
A Persad ◽  
K Meguro
Keyword(s):  
Intracranial Hypertension ◽  
Treatment Modality ◽  
Idiopathic Intracranial Hypertension ◽  
Laparoscopic Approach ◽  
Normal Pressure ◽  
Peritoneal Catheter ◽  
Single Centre ◽  
Lumboperitoneal Shunt ◽  
Csf Diversion ◽  
Established Treatment

Background: Ventriculoperitoneal (VP) shunts are an established treatment modality for CSF diversion. An alternative to VP shunting is lumboperitoneal (LP) shunting. There is a paucity of evidence on LP shunt use in the literature, but available studies demonstrate that it is a safer and similarly efficacious method for conditions such as normal pressure hydrocephalies (NPH) and idiopathic -intracranial hypertension (IIH). Methods: Ventriculoperitoneal (VP) shunts are an established treatment modality for CSF diversion. An alternative to VP shunting is lumboperitoneal (LP) shunting. There is a paucity of evidence on LP shunt use, but available studies demonstrate that it is a safer and similarly efficacious method for conditions such as normal pressure hydrocephalies (NPH) and idiopathic intracranial hypertension (IIH). Results: 95 patients were treated with lumboperitoneal shunt, 71 of which were for hydrocephalus and 24 for IIH. 39 male and 58 female patients were included with mean age 55 (range from 20 to 96 years old). 26 patients had laparoscopic placement of the peritoneal catheter. Mechanical issues with distal end was less with laparoscopic approach. Conclusions: We will review disease-specific scores for NPH and IIH, and compare laparoscopic with non-laparoscopic placement of peritoneal catheter. We will also compare outcomes and complications with rates for VP shunting.

INFECTIOUS COMPLICATIONS OF TEMPORARY SPINAL CATHETER INSERTION FOR DIAGNOSIS OF ADULT HYDROCEPHALUS AND IDIOPATHIC INTRACRANIAL HYPERTENSION

Neurosurgery ◽  
2008 ◽  
Vol 62 (2) ◽  
pp. 431-436 ◽  
Author(s):  
Benjamin M. Greenberg ◽  
Michael A. Williams
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Hypertension ◽  
Infection Rate ◽  
Normal Pressure Hydrocephalus ◽  
Idiopathic Intracranial Hypertension ◽  
Normal Pressure ◽  
Catheter Insertion ◽  
Antibiotic Administration ◽  
Cerebrospinal Fluid Drainage ◽  
Spinal Catheter

Abstract OBJECTIVE Spinal catheters are often inserted for treatment of cerebrospinal fluid leaks; however, they have recently been recommended for elective cerebrospinal fluid drainage to identify patients with possible normal pressure hydrocephalus who are most likely to respond to shunt surgery. The rate of spinal catheter-associated meningitis with elective spinal catheter insertion is unknown. The objective was to determine the rate of infection and risk factors associated with elective spinal catheter insertion for evaluation of hydrocephalus and idiopathic intracranial hypertension (IIH). METHODS We retrospectively analyzed clinical and microbiological data and cerebrospinal fluid results of patients admitted during 60 consecutive months who had elective spinal catheter insertion for evaluation of normal pressure hydrocephalus or IIH. RESULTS A total of 461 spinal catheters were inserted in 454 patients, including 419 (90.9%) for treatment of hydrocephalus and 42 (9.1%) for IIH. The infection rate was 3.3% (15 out of 461 patients) for the entire cohort, 3.6% (15 out of 419 patients) for the hydrocephalus cohort, and 0% for the IIH cohort. There was one death (0.2%) in the hydrocephalus cohort. The infection rate was reduced and sustained at 1.8% for 225 catheters after the topical antiseptic was changed to chlorhexidine (two-sided Fisher's exact test; P = 0.114). CONCLUSION Although infection is the most serious complication of spinal catheter insertion for evaluation of hydrocephalus or IIH, the infection rate can be maintained below 2% with use of chlorhexidine topical antiseptic application, single-dose preprocedural antibiotic administration, and clinical surveillance of the patient. The benefit of cerebrospinal fluid drainage via spinal catheter for normal pressure hydrocephalus outweighs the risks associated with the procedure.

Reversible intracranial hypertension following treatment of an extracranial vascular malformation: case report

2019 ◽  
Vol 23 (3) ◽  
pp. 369-373 ◽  
Author(s):  
Katie Pricola Fehnel ◽  
Jennifer Klein ◽  
Benjamin C. Warf ◽  
Edward R. Smith ◽  
Darren B. Orbach
Keyword(s):  
Case Report ◽  
Intracranial Hypertension ◽  
Pediatric Population ◽  
Superficial Temporal Artery ◽  
Vascular Anomaly ◽  
Temporal Artery ◽  
Normal Pressure ◽  
Third Ventriculostomy ◽  
Related Disorder ◽  
Csf Diversion

Pediatric hydrocephalus is a well-studied and still incompletely understood entity. One of the physiological means by which hydrocephalus and intracranial hypertension evolve is through perturbations to normal vascular dynamics. Here the authors report a unique case of an extracranial vascular anomaly resulting in persistently elevated intracranial pressures (ICPs) independent of CSF diversion in a patient with a Joubert syndrome–related disorder. The patient developed worsening intracranial hypertension after successful CSF diversion of Dandy-Walker malformation–associated hydrocephalus via endoscopic third ventriculostomy–choroid plexus cauterization (ETV/CPC). Vascular workup and imaging revealed an extracranial arteriovenous fistula of the superficial temporal artery at the site of a prior scalp intravenous catheter. Following microsurgical obliteration of the lesion, ICP normalized from > 30 cm H2O preoperatively to 11 cm H2O postoperatively. A repeat lumbar puncture at 4 months postoperatively again demonstrated normal pressure, and the patient remained asymptomatic for 9 months. Recurrent symptoms at 9 months were attributed to inadequate CSF diversion, and the patient underwent ventriculoperitoneal shunt placement. This is the first report of an extracranial-to-extracranial vascular anastomosis resulting in intracranial hypertension. This case report demonstrates the need to consider extracranial vascular anomalies as potential sources of persistently elevated ICP in the syndromic pediatric population.

scholarly journals Total improvement after surgery for obstructive sleep apnea syndrome in a patient with concurrent malignant idiopathic intracranial hypertension

2019 ◽  
Vol 131 (2) ◽  
pp. 582-586 ◽  
Author(s):  
Halil Onder ◽  
Onur Ergun ◽  
Mehmet Kaygisiz ◽  
I. Samet Daltaban
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Intracranial Hypertension ◽  
Obstructive Sleep Apnea Syndrome ◽  
Idiopathic Intracranial Hypertension ◽  
Sleep Apnea Syndrome ◽  
Total Recovery ◽  
Lumboperitoneal Shunt ◽  
Obstructive Sleep ◽  
Apnea Syndrome

The association between idiopathic intracranial hypertension (IIH) and obstructive sleep apnea syndrome (OSAS) constitutes an interesting point of discussion regarding clinical approaches as well as the underlying pathophysiological mechanisms. Here, the case of a 42-year-old female with malignant IIH and OSAS is illustrated. Initially, the patient was treated with lumboperitoneal shunt surgery. However, OSAS surgery provided total recovery from the recurrent symptoms developing secondary to lumboperitoneal shunt malfunction. The authors point out the importance of identifying OSAS as a crucial causative agent in some IIH subtypes. Future studies are warranted to clarify this underestimated association.

Sign in / Sign up

Export Citation Format

Share Document