scholarly journals Pseudomeningocoele after baclofen pump placement in a child: a case report and preventive measures

2017 ◽  
Vol 31 (4) ◽  
pp. 536-539
Author(s):  
Rahul Gupta ◽  
Abhay Singh ◽  
Gangesh Gunjan ◽  
Harjinder Singh Bhatoe
Keyword(s):  
Cerebral Palsy ◽  
Case Report ◽  
Pediatric Patient ◽  
Preventive Measures ◽  
Adult Population ◽  
Intrathecal Baclofen ◽  
Csf Leak ◽  
Intrathecal Baclofen Therapy ◽  
Pump Placement ◽  
Pump Implantation

Abstract Intrathecal baclofen therapy is a well-established means of treating intractable spasticity and dystonia in paediatric as well as adult population. Complications of baclofen pump placement include infection, malfunctioning and refraction to baclofen. We report a case of eight year child suffering from spasticity due to cerebral palsy, who developed pseudomeningocoele due to peri-catheter leak. Steps and precaution pertaining to pump implantation in a child are discussed. Baclofen pump insertion in a child needs some extra precautions due to non-availability of pediatric implants and poor built of the pediatric patient to adjust with a bulky device. Preventive measures should be taken to prevent peri-catheter CSF leak.

Analysis of complications in 430 consecutive pediatric patients treated with intrathecal baclofen therapy: 14-year experience

2014 ◽  
Vol 13 (3) ◽  
pp. 301-306 ◽  
Author(s):  
Francesco Motta ◽  
Clara E. Antonello
Keyword(s):  
Adverse Events ◽  
Temporal Distribution ◽  
Intrathecal Baclofen ◽  
Csf Leak ◽  
Children And Adolescent ◽  
Intrathecal Baclofen Therapy ◽  
Single Center Study ◽  
Different Origins ◽  
Pump Implantation

Object This single-center study investigated adverse events that occurred in children and adolescent patients treated with intrathecal baclofen (ITB) therapy for spasticity and/or dystonia. Methods In a 14-year period, 430 consecutive patients with a mean age of 13.3 ± 5.9 years received ITB over a mean follow-up period of 8.6 ± 3.8 years (range 12 months to 14 years). Eighty-nine percent of these patients had cerebral palsy. Major complications, defined as those that required a surgical intervention, were infections, CSF leaks, and device problems related to the catheter or pump. Assessing infections, the authors compared the 2 groups of patients implanted with an ITB system by either the subcutaneous or subfascial technique. The temporal distribution of events related to the catheter was also considered. Results At least 1 complication was present in 25% of the patients: 9.3% experienced an infection, 4.9% a CSF leak, 15.1% a problem with the catheter, and 1% a problem related to the pump. Five percent of the assessed patients suffered more than 1 complication. The rate of infections was significantly lower (p < 0.001) in patients with the pump placed subfascially compared with those with the pump placed subcutaneously. A higher rate of infection was found after pump replacement compared with the first pump implantation (10.6% vs 6%, respectively). Catheter problems were the most common complication and occurred more frequently during the 1st year after the implant. Conclusions While ITB is an effective treatment to manage spasticity of different origins, adverse events may occur and need to be managed. The surgical procedure should be meticulous and different techniques may have a diverse impact on the infection rate, which is the most critical complication. Despite the adverse events that occurred in this study, the majority of patients were satisfied with the treatment received.

Dose-dependent Changes in Gait Pattern after Intrathecal Baclofen Bolus Injection in Adult Ambulatory Cerebral Palsy: A Case Report

2015 ◽  
Vol 8 (2) ◽  
pp. 104
Author(s):  
Yoon-Kyum Shin ◽  
Ae Ryung Kim ◽  
Jin Woo Chang ◽  
Won Seok Chang ◽  
Don Shin Lee ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Case Report ◽  
Bolus Injection ◽  
Intrathecal Baclofen ◽  
Gait Pattern ◽  
Dose Dependent

Occult Hydrocephalus in Children with Cerebral Palsy

Neurosurgery ◽  
2005 ◽  
Vol 56 (1) ◽  
pp. 93-97 ◽  
Author(s):  
A Leland Albright ◽  
Susan Ferson ◽  
Signe Carlos
Keyword(s):  
Cerebral Palsy ◽  
Periventricular Leukomalacia ◽  
Intrathecal Baclofen ◽  
Multicenter Studies ◽  
Csf Shunts ◽  
Csf Pressure ◽  
Intrathecal Baclofen Therapy ◽  
Children With Cerebral Palsy ◽  
Csf Leaks

Abstract OBJECTIVE: Many children with cerebral palsy have chronic ventriculomegaly as a consequence of perinatal intraventricular hemorrhage or periventricular leukomalacia, without symptoms of hydrocephalus. Children with cerebral palsy who are treated with intrathecal baclofen have a higher rate of cerebrospinal fluid (CSF) leaks along the baclofen catheter than do adults treated with intrathecal baclofen. We postulated that the cause of the increased frequency of CSF leaks was increased CSF pressure, that is, occult hydrocephalus. METHODS: Lumbar punctures were performed in 24 children with cerebral palsy and asymptomatic ventriculomegaly. Their median age was 4.7 years. Mild or moderate ventriculomegaly was present in 23 children and severe ventriculomegaly was present in 1 child. RESULTS: Opening pressures were abnormally high in 23 (96%) of 24 children and ranged from 22 to 41 cm H2O (mean, 27.3 cm H2O). Opening pressures did not correlate with the extent of ventriculomegaly. CONCLUSION: Children with cerebral palsy and ventriculomegaly seem to have a high incidence of increased CSF pressure, and thus, of occult hydrocephalus. The increased pressure is probably a significant cause of the increased frequency of CSF leaks for these children during intrathecal baclofen therapy. The long-term risks of untreated increased CSF pressures in this patient population are not known but are cause for concern. Treatment with CSF shunts offers the potential of improved development, which was reported anecdotally in some children who were treated with ventriculoperitoneal shunts after their pressure was found to be increased. Prospective multicenter studies of this problem are needed.

Poster 442 Urinary Retention Secondary to an Intrathecal Baclofen Pump Placement: Case Report and Literature Review

PM&R ◽  
2011 ◽  
Vol 3 ◽  
pp. S328-S328
Author(s):  
Michelle Weiner ◽  
Seema R. Khurana ◽  
Jose Ramil O. Santos
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Urinary Retention ◽  
Intrathecal Baclofen ◽  
Pump Placement
Sign in / Sign up

Export Citation Format

Share Document