Delayed Intracerebral Hemorrhage after Ventriculoperitoneal Shunting

Neurosurgery ◽  
1986 ◽  
Vol 19 (2) ◽  
pp. 305-307 ◽  
Author(s):  
Robert B. Snow ◽  
Robert D. Zimmerman ◽  
Orrin Devinsky
Keyword(s):  
Blood Vessel ◽  
Intracerebral Hemorrhage ◽  
Rare Complication ◽  
Ventricular Catheter ◽  
Review Of The Literature ◽  
Cerebral Blood Vessel ◽  
Maximal Diameter ◽  
Ventriculoperitoneal Shunting ◽  
Shunting Procedure ◽  
Ventricular Shunting

Abstract A rare complication of ventriculoperitoneal shunting is presented. In this case, a moderate-sized intracerebral hemorrhage (3 to 5 cm in maximal diameter) occurred 1 week after operation for idiopathic hydrocephalus in a 43-year-old woman. The patient recovered fully without operative intervention. No other case of delayed intracerebral hemorrhage after a ventricular shunting procedure was found in a review of the literature. The presumed mechanism in the present case is delayed erosion of a cerebral blood vessel by the ventricular catheter.

scholarly journals Ischemic bowel secondary to ventriculoperitoneal shunt knotting: a surprisingly rare complication of ventriculoperitoneal shunting. Case report

2020 ◽  
Vol 25 (5) ◽  
pp. 470-475
Author(s):  
Kathryn Alana Joy ◽  
Benjamin Stephan Szewczyk ◽  
Matthew Armand Adamo ◽  
Mary Christina Whyte
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Rare Complication ◽  
Rare Event ◽  
Review Of The Literature ◽  
Bowel Necrosis ◽  
Comprehensive Review ◽  
Ischemic Bowel ◽  
Ventriculoperitoneal Shunting ◽  
Bowel Strangulation

Small-bowel obstruction (SBO) and volvulus as a result of ventriculoperitoneal shunting are a rare phenomenon, especially when resulting in bowel necrosis. The authors report the rare event of SBO, bowel strangulation, and necrosis in a pediatric patient after the abdominal catheter became knotted around his small bowel, and they provide a comprehensive review of the literature. The authors argue that shunt configuration is an important consideration for a patient presenting with SBO, and that symptomatic shunt knotting is a reason for surgical correction.

scholarly journals Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stefano Granieri ◽  
Francesco Sessa ◽  
Alessandro Bonomi ◽  
Sissi Paleino ◽  
Federica Bruno ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Symptoms ◽  
Rare Complication ◽  
Meta Analysis ◽  
Treatment Options ◽  
Palliative Surgery ◽  
Review Of The Literature ◽  
Colovesical Fistula ◽  
Level Of Evidence ◽  
Meta Analyses

Abstract Background Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are necessary not only to confirm the presence of the fistula, but more importantly to demonstrate the extent and the nature of the fistula. There is still a lack of consensus regarding the if, when and how to repair the fistula. The aim of the study is to review the different surgical treatment options, focus on surgical indications, and explore cumulative recurrence, morbidity, and mortality rates of entero-vesical and colo-vesical fistula patients. Methods A systematic review of the literature was conducted according to PRISMA guidelines. Random effects meta-analyses of proportions were developed to assess primary and secondary endpoints. I2 statistic and Cochran’s Q test were computed to assess inter-studies’ heterogeneity. Results Twenty-two studies were included in the analysis with a total of 861 patients. Meta-analyses of proportions pointed out 5, 22.2, and 4.9% rates for recurrence, complications, and mortality respectively. A single-stage procedure was performed in 75.5% of the cases, whereas a multi-stage operation in 15.5% of patients. Palliative surgery was performed in 6.2% of the cases. In 2.3% of the cases, the surgical procedure was not specified. Simple and advanced repair of the bladder was performed in 84.3% and 15.6% of the cases respectively. Conclusions Although burdened by a non-negligible rate of complications, surgical repair of entero-colovesical fistula leads to excellent results in terms of primary healing. Our review offers opportunities for significant further research in this field. Level of Evidence Level III according to ELIS (SR/MA with up to two negative criteria).

Delayed leukoencephalopathy from suspected polymer embolism after neuroendovascular procedures

2021 ◽  
pp. 197140092110291
Author(s):  
Thomas Mellemkjær ◽  
Ronil V Chandra ◽  
Lasse Speiser ◽  
Benedicte P Ulhøi ◽  
Claus Z Simonsen
Keyword(s):  
Polymer Material ◽  
Endovascular Procedures ◽  
Rare Complication ◽  
Diagnostic Process ◽  
Line Treatment ◽  
Review Of The Literature ◽  
First Line ◽  
Stroke Treatment ◽  
Oral Glucocorticoids ◽  
First Line Treatment

As the neurointervention field grows, a new side effect emerges. Delayed leukoencephalopathy (DL) is believed to be an inflammatory or allergic reaction to polymer material that is shed from catheters during endovascular procedures. We present four cases of DL after aneurysm treatment in two patients, endovascular stroke treatment and diagnostic arteriography. We present our diagnostic process, including biopsy results in two patients, our anti-inflammatory treatment and outcomes together with a review of the literature. In our series, prognosis was variable with ongoing seizures in two patients. Our literature review reveals that asymptomatic shedding of polymer material is common, occurring in a third of endovascular stroke procedures, whereas symptomatic DL occurs in <0.5% of therapeutic neuroendovascular procedures. Clinicians should be aware of this rare complication, and oral glucocorticoids seem to be a reasonable first-line treatment strategy.

scholarly journals Pneumothorax as a rare complication during laparoscopic total extra-peritoneal inguinal hernia repair: A case report and review of the literature

2021 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
Dimitrios Papaconstantinou ◽  
Nikolaos Koliakos ◽  
Andrianos-Serafeim Tzortzis ◽  
Dimitrios Schizas ◽  
Dimitrios Bistarakis ◽  
...  
Keyword(s):  
Case Report ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Rare Complication ◽  
Review Of The Literature

scholarly journals Cerebral Blood Vessel Response to L-dopa and Inhibitor of Peripheral Decarboxylase in Stroke-prone SHR (SHRSP), Stroke-resistant SHR (SHRSR) and Wistar-Kyoto (WKY) Rats

1980 ◽  
Vol 21 (4) ◽  
pp. 574-574
Author(s):  
Krystyna Skolasinska ◽  
Yukio Yamori ◽  
Masahiro Kihara ◽  
Katsumi Ikeda ◽  
Yasuo Nara ◽  
...  
Keyword(s):  
Blood Vessel ◽  
Cerebral Blood Vessel ◽  
Wky Rats ◽  
Vessel Response ◽  
Wistar Kyoto

Abstract 3802: Retinal Vasoreactivity as a Marker of Impaired Cerebral Function in Diabetes

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Julia E Slocomb ◽  
Mary E Lott ◽  
Vikram Shivkumar ◽  
Kerstin Bettermann
Keyword(s):  
Blood Vessel ◽  
Cerebrovascular Disease ◽  
Breath Hold ◽  
Mean Flow ◽  
Cerebral Blood Vessel ◽  
Cerebrovascular Function ◽  
Venous Diameter ◽  
Light Flicker ◽  
The Impact ◽  
Flicker Stimulus

The eye and the brain share embryological, anatomic and physiological similarities, which suggest that the retinal microvasculature may be an ideal surrogate marker of cerebrovascular function. This is intriguing, as the cerebral vasculature cannot be directly measured in a non-invasive manner. In epidemiological studies abnormal retinal Arteriovenous Ratios (AVR) are associated with an increased risk of stroke and cerebrovascular disease. However, the association between retinal vasoreactivity measurements and cerebral blood vessel function remains unknown. An attenuated retinal vasoreactivity may indicate endothelial dysfunction in the eye and brain and may prove to be useful as a marker of cerebrovascular disease in high risk populations such as in diabetics. STUDY GOALS: To examine 1) the impact of diabetes at different disease stages on measures of cerebrovascular function and 2) the relationship between retinal blood vessel reactivity, retinal AVRs and measures of cerebral small vessel function. METHODS: This cohort study included 29 type 2 diabetics, 14 pre-diabetics, and 14 healthy controls (ages: 37 to 75 years). Retinal vasoreactivity was measured with the Dynamic Vessel Analyzer (Imedos, Jena, Germany) following high frequency flicker light stimulation. Cerebrovascular blood flow velocity of the Middle Cerebral Artery (MCA) was assessed by Transcranial Doppler Ultrasound (TCD) (Siemens, USA). RESULTS: Progression of diabetes was found to be significantly associated with attenuation of light flicker stimulus response (P=0.0009 artery, P=0.0001 vein, CI 95%), AVR (P=0.0070, CI 95%), PI (P=0.0202, CI 95%), RI (P=0.0033, CI 95%) and hyperventilation-breath hold (P≤0.0001, CI 95%). Across all groups, attenuated retinal arterial and venous diameter responses to the light flicker stimulus were associated with an increase in MCA RI (P=0.02, r=-0.30 artery, P=0.06, r=-0.24 vein, CI 95%). An attenuated venous diameter response was associated with an increase in PI (P=0.02, r=-0.29 vein, CI 95%). In addition, attenuated retinal diameter responses were also associated with a decrease in MCA mean flow velocities following hyperventilation-breath hold (P=0.05, r=0.26 artery, P=0.01, r=0.34 vein, CI 95%). Attenuated retinal responses were also correlated with a reduction in AVR (P=0.05, r=0.26 artery, P=0.15, r=0.19 vein, CI 95%). CONCLUSION: Impairment of retinal vasoreactivity is associated with cerebrovascular dysfunction across the continuum of diabetes, possibly indicating that the eye reflects changes in cerebral blood vessel function and stroke risk.

Chyle leak following total colectomy for ulcerative colitis: a case report and review of the literature

2021 ◽  
Vol 103 (7) ◽  
pp. e231-e233
Author(s):  
CF Brewer ◽  
Y Al-Abed
Keyword(s):  
Ulcerative Colitis ◽  
Total Colectomy ◽  
Rare Complication ◽  
Elemental Diet ◽  
Lymphatic Drainage ◽  
Effective Management ◽  
Review Of The Literature ◽  
Chyle Leak ◽  
Surgical Options ◽  
Inflammatory Bowel

Chyle leak is a rare complication in colorectal surgery. It occurs due to disruption of the lymphatic drainage network in the abdomen or retroperitoneum. We describe the first reported case of chyle leak following total colectomy for inflammatory bowel disease. Our patient underwent total colectomy for severe ulcerative colitis not responsive to medical treatment. Four days postoperatively, a milky fluid was noted in the drainage bag. Analysis of the fluid confirmed chyle. The patient remained well and was successfully managed conservatively with a fat-free elemental diet and was discharged from hospital on day 12 postoperatively. A review of the literature suggests that conservative management with dietary modification is a common and effective management strategy; however, medical and surgical options exist for refractory cases.

STEREOTACTIC VENTRICULOPERITONEAL SHUNTING FOR REFRACTORY IDIOPATHIC INTRACRANIAL HYPERTENSION

Neurosurgery ◽  
2007 ◽  
Vol 60 (6) ◽  
pp. 1039-1044 ◽  
Author(s):  
Basel Abu-Serieh ◽  
Keyvan Ghassempour ◽  
Thierry Duprez ◽  
Christian Raftopoulos
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Long Term Results ◽  
Ventricular Catheter ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Visual Deficits ◽  
Ventriculoperitoneal Shunting

Abstract OBJECTIVE Recent reports have shown promising short- to medium-term results in patients with refractory idiopathic intracranial hypertension (IIH) treated using the stereotactic ventriculoperitoneal shunting (SVPS) technique. However, the long-term clinical efficacy of this technique remains questionable. This report provides the long-term results of SVPS in treating refractory IIH patients. METHODS We reviewed the medical charts of nine consecutive patients (mean age, 26.4 yr; range, 4–63 yr) treated using either a frame-based or frameless SVPS technique for IIH. RESULTS The mean postoperative follow-up period was 44.3 months (range, 6–110 mo). Before shunting procedures were performed, each patient presented with intractable headache, and five patients (55.6%) had mild to moderate visual deficits. The last follow-up assessment showed that after shunting was performed, eight patients (89%) were headache-free. Only one patient had recurrent headache; however, this patient's pain was much less frequent and severe than before the shunting procedure was completed and was concomitant with recent weight increase. Visual deficits were resolved in three patients and remained stable in two who already had optic nerve atrophy before shunting was completed. Twelve SVPS procedures were performed on our patients. Nine shunt revisions were needed in six patients because of infection (n = 5, including two revisions in one patient), valve dysfunction (n = 2), distal obstruction (n = 1), and ventricular catheter malpositioning (n = 1). No patient had proximal catheter obstruction. CONCLUSION Given the favorable long-term outcome of the SVPS technique for refractory IIH, we are encouraged to apply this procedure on our patients. More invasive approaches should be reserved for patients who have SVPS failure.

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