Metastatic Tuberculomas along a Nonfunctioning Ventricular Catheter

Abstract Objective Ventriculoperitoneal shunt (VPS) placement is one of the most frequent neurosurgical procedures. The position of the proximal catheter is important for shunt survival. Shunt placement is done either without image guidance (“freehand”) according to anatomical landmarks or by use of various image-guided techniques. Studies evaluating ultrasound-guided (US-G) VPS placement are sparse. We evaluate the accuracy and feasibility of US-G VPS placement, and compare it to freehand VPS placement. Methods We prospectively collected data of consecutive patients undergoing US-G VPS placement. Thereafter, the US cohort was compared with a cohort of patients in whom VPS was inserted using the freehand technique (freehand cohort). Primary outcome was accuracy of catheter positioning, and secondary outcomes were postoperative improvement in Evans' index (EI), rates of shunt dysfunction and revision surgery, perioperative complications, as well as operation, and anesthesia times. Results We included 15 patients undergoing US-G VPS insertion. Rates of optimally placed shunts were higher in the US cohort (67 vs. 49%, p = 0.28), whereas there were no malpositioned VPS (0%) in the US cohort, compared with 10 (5.8%) in the freehand cohort (p = 0.422). None of the factors in the univariate analysis showed significant association with nonoptimal (NOC) VPS placement in the US cohort. The mean EI improvement was significantly better in the US cohort than in the freehand cohort (0.043 vs. 0.014, p = 0.035). Conclusion Based on our preliminary results, US-G VPS placement seems to be feasible, safe, and increases the rate of optimally placed catheters.

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The role of simultaneous abdominal surgery and wound classification in ventriculoperitoneal shunt complication

Pediatric Surgery International ◽

10.1007/s00383-017-4167-3 ◽

2017 ◽

Vol 33 (11) ◽

pp. 1221-1230

Author(s):

Shin Miyata ◽

Jamie Golden ◽

Olga Lebedevskiy ◽

James E. Stein ◽

David W. Bliss

Keyword(s):

Abdominal Surgery ◽

Ventriculoperitoneal Shunt ◽

Shunt Complication ◽

Wound Classification

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Rapid Evaluation of Ventriculoperitoneal Shunt Function in a Pediatric Patient Using Emergency Ultrasound

Pediatric Emergency Care ◽

10.1097/pec.0b013e318262ccef ◽

2012 ◽

Vol 28 (7) ◽

pp. 726-727 ◽

Cited By ~ 3

Author(s):

Leah Marion Hamburg ◽

David O. Kessler

Keyword(s):

Pediatric Patient ◽

Ventriculoperitoneal Shunt ◽

Emergency Ultrasound ◽

Rapid Evaluation

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Subgaleal Migration of the Distal Catheter of a Ventriculoperitoneal Shunt

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2016.109 ◽

2009 ◽

Vol 52 (2) ◽

pp. 77-79 ◽

Cited By ~ 1

Author(s):

Fatih Serhat Erol ◽

Bekir Akgun

Keyword(s):

Ventriculoperitoneal Shunt ◽

Ventricular Catheter ◽

Peritoneal Catheter ◽

Shunt Valve ◽

Distal Catheter ◽

X Ray ◽

Proximal Migration ◽

Shunt Dysfunction ◽

Valve Placement ◽

The Brain

Proximal migration of the distal end of a ventriculoperitoneal shunt has been observed much more rarely than other numerous shunt-related complications. Subgaleal migration of the peritoneal end is one of the samples. In the preset report we have discussed a case of subgaleal migration of the peritoneal end detected as a result of the examinations performed for shunt dysfunction. There was ventricular dilatation on CT scan of the brain. X-ray examinations confirmed proper ventricular catheter and shunt valve placement but a complete migration of distal (peritoneal) catheter into the subgaleal space. Then the patient’s shunt was revised. When our case and the literature were examined, we observed that this complication was frequently encountered during the first postoperative months, in the pediatric ages and in patients with advanced hydrocephalus. Besides, we have detected that the peritoneal catheters had tendency to migration into the subgaleal tissues similar to pre-insertion forms of the preoperatively original packages.

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Potential Risk Factors for Ventriculoperitoneal Shunt Implantation in Paediatric Patients with Posthemorrhagic Hydrocephalus of Prematurity Treated with Subcutaneous Reservoir: An Institutional Experience

Neuropediatrics ◽

10.1055/s-0041-1732311 ◽

2021 ◽

Author(s):

Adam K. Bębenek ◽

Stanisław Kwiatkowski ◽

Olga Milczarek

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Ventriculoperitoneal Shunt ◽

Gestational Age ◽

Potential Risk ◽

Statistical Significance ◽

Skin Lesions ◽

Ventricular Catheter ◽

Posthemorrhagic Hydrocephalus ◽

Medical Health Care

Abstract Background Posthemorrhagic hydrocephalus of prematurity (PHHP) is a result of intraventricular hemorrhage (IVH). IVH occurs in 6 to 23% of the preterms in countries with advanced medical health care. Most of these patients will eventually require the use of ventriculoperitoneal shunt (VPS). The purpose of this study is to assess the risk factors of VPS implantation in patients with PHHP who have been treated with ventricular catheter with subcutaneous reservoir (VCSR). Methods The retrospective study was conducted evaluating 35 premature patients who suffered from severe IVH. Their mean gestational age was 28 weeks. The assessment included antenatal factors such as gestational age, birth weight, and intrauterine and perinatal infection. Postparturient period factors such as the IVH grade, time between diagnosis, and VCSR implantation and body weight on VCSR implantation were also considered in the study. Postprocedural complications, such as bacterial cerebrospinal fluid (CSF) infection, sepsis, and skin lesions, were evaluated. Data were calculated with R program, version 4.04. Results From among 35 evaluated patients, 23 (65.71%) required a VPS. Median of birth weight was 1,190 g. Infections were observed in 11 (31.43%) cases. Mean time between IVH diagnosis and VCSR implantation was 2.6 weeks. Postprocedural complications occurred in 19 (54.29%) patients. None of the evaluated factors has proven its statistical significance (p > 0.05) for being a potential risk factor for VPS implantation. Conclusion External factors seem to not affect the necessity of VPS implantation in patients after the severe IVH. Ostensibly, there seems to be no difference between the grades III and the IV of Papile's IVH scale regarding VPS implantation necessity.

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A Unique Case of a Pediatric Patient With Blastic Plasmacytoid Dendritic Cell Neoplasm, Guillain Barre Syndrome, and Hemophagocytic Lymphohistiocytosis

Journal of Pediatric Hematology/Oncology ◽

10.1097/mph.0000000000001464 ◽

2020 ◽

Vol 42 (5) ◽

pp. e392-e393

Author(s):

Chelsea Penney ◽

Donna L. Johnston ◽

Eden Story

Keyword(s):

Dendritic Cell ◽

Pediatric Patient ◽

Hemophagocytic Lymphohistiocytosis ◽

Plasmacytoid Dendritic Cell ◽

Guillain Barre Syndrome ◽

Unique Case ◽

Guillain Barré Syndrome ◽

Cell Neoplasm ◽

Guillain Barré

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Relationship of the Location of the Ventricular Catheter Tip and Function of the Ventriculoperitoneal Shunt

Bangladesh Journal of Neurosurgery ◽

10.3329/bjns.v9i1.42919 ◽

2019 ◽

Vol 9 (1) ◽

pp. 16-21

Author(s):

DM Arman ◽

Sheikh Muhammad Ekramullah ◽

Sudipta Kumer Mukherjee ◽

Joynul Islam ◽

Mirza Hafizur Rashid ◽

...

Keyword(s):

Ventriculoperitoneal Shunt ◽

Significant Proportion ◽

Catheter Placement ◽

Ventricular Catheter ◽

Shunt Procedure ◽

Freehand Technique ◽

Catheter Tip ◽

And Function ◽

Relationship Of ◽

The Relationship

Object: The objective of this study was to determine the relationship of the location of the ventricular catheter tip and function of the ventriculoperitoneal shunt. Methods: This prospective observational study included 140 patients from a single institution who underwent a ventriculoperitoneal shunt procedure in which a new ventricular catheter was placed between September, 2013 and September 2016. Data abstracted for each patient included age, sex, diagnosis, site and side of ventricular catheter placement. Postoperative CT scan images were reviewed for accuracy of ventricular catheter placement. Patients were followed up over 2 ½ to 4 ½ years.63 patients were available for follow up. We lost communication with rest of the patients. The relationship of the location of the ventricular catheter tip and function of the ventriculoperitoneal shunt was analyzed in 63 patients. Results: There were 140 patients included in the study; accuracy ventricular catheter tip placement were 55 (39.28%) using freehand technique. VP shunt functioned well in 43 (68.25%) of 63 patients. Among the 43 patients with well functioning shunt ,19 were in accurate group ,7 were in suboptimal group and 17 were in inaccurate group.26 patients (41.27%) had good outcome with normal development and normal IQ Conclusions: Mechanical malfunction and infection are the most significant problems associated with shunts for the treatment of hydrocephalus. Above all, a significant proportion of shunt failure was due to obstruction of the ventricular catheter, and accurate placement of the shunt catheter is highly important to reduce the incidence of shunt malfunction. Bang. J Neurosurgery 2019; 9(1): 16-21

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A Unique Case of Multiple Sites of Pneumatization of the Sinonasal Bony Framework in a Pediatric Patient

Ear Nose & Throat Journal ◽

10.1177/014556131008901103 ◽

2010 ◽

Vol 89 (11) ◽

pp. E10-E11 ◽

Cited By ~ 2

Author(s):

Georgios Giourgos ◽

Elina Matti ◽

Paolo Carena ◽

Fabio Pagella

Keyword(s):

Pediatric Patient ◽

Pediatric Population ◽

Inferior Turbinate ◽

Anatomic Variations ◽

Concha Bullosa ◽

Unique Case ◽

Pediatric Case

Anatomic variations of the sinonasal bony framework in the pediatric population are quite common. In children with such variations, however, bony pneumatization is uncommon. Moreover, pneumatization of the inferior turbinate in children is extremely rare; to the best of our knowledge, only 3 cases have been previously reported in the literature–none of which involved additional pneumatization variations of the sinonasal skeleton. Herein we present a new pediatric case that was unique in that an inferior concha bullosa coexisted with rarely seen pneumatized anatomic structures.

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