Continuous intraventricular vancomycin for treatment of ventriculitis using IRRAflow®: A case report

Background: Ventriculitis usually occurs as the result of infection and results in the inflammation of the ependymal lining of the ventricular system. Mortality rates remain high despite treatment. Case Description: We present the case of a 66-year-old man who presented with altered mental status and progressively became comatose. He was found to have fulminant ventriculitis due to a ruptured intracranial abscess. He was treated with bilateral IRRAflow® catheter (IRRAS, Stockholm, Sweden) placement through which continuous irrigation with vancomycin was initiated. Conclusion: This treatment was safe and led to improvement in the patient’s neurologic examination, imaging findings, and cerebrospinal fluid profiles.

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Confusional State in HaNDL Syndrome: Case Report and Literature Review

Case Reports in Neurological Medicine ◽

10.1155/2013/317685 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Sarah Nelson

Keyword(s):

Cerebrospinal Fluid ◽

Case Report ◽

Literature Review ◽

Mental Status ◽

Clinical Manifestation ◽

English Language ◽

Altered Mental Status ◽

Confusional State ◽

Limited Condition ◽

Confusional States

The syndrome of transient headache and neurologic deficits with cerebrospinal fluid lymphocytosis (HaNDL syndrome) is a self-limited condition. Confusional states are uncommonly reported as a clinical manifestation of this syndrome. Here, I report a 76-year-old female who presented with headache, confusion, and agitation with a mild CSF lymphocytosis. Other workup to determine the cause of her altered mental status was otherwise negative. The literature available in the English language on HaNDL syndrome is reviewed, including its history, pathophysiology, possible associations with migraine and stroke, and previously reported cases of confusional states in this syndrome. While HaNDL syndrome has been a described entity since the 1980s, its pathophysiology has yet to be clearly defined.

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Hepatic Liquoric Cyst as a Complication of Ventriculoperitoneal Shunt Insertion: A Case Report

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0041-1732441 ◽

2021 ◽

Author(s):

Lívio Pereira de Macêdo ◽

Arlindo Ugulino Netto ◽

Kauê Franke ◽

Pierre Vansant Oliveira Eugenio ◽

Lucas Ribeiro de Moraes Freitas ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Case Report ◽

Ventriculoperitoneal Shunt ◽

Individual Case ◽

Abdominal Imaging ◽

Case Description ◽

Shunt Insertion ◽

Important Complication ◽

History Of

Abstract Background The ventriculoperitoneal shunt (VPS) procedure is still the most used technique for management of hydrocephalus. This article reports a case of hepatic cerebrospinal fluid (CSF) pseudocyst as a rare, but important, complication of the VPS insertion. Case Description An 18-year-old male presented to the hospital complaining of temporal headache and visual turbidity for approximately 3 months with a history of VPS insertion for treatment of hydrocephalus and revision of the valve in adolescence. The diagnosis was based on abdominal imaging, demonstrating an extra-axial hepatic CSF pseudocyst free from infection. Following the diagnosis, the management of the case consisted in the removal and repositioning of the catheter on the opposite site of the peritoneum. Conclusion The hepatic CSF pseudocyst is an infrequent complication of VPS procedure, but it needs to be considered when performing the first evaluation of the patient. Several techniques are considered efficient for the management of this condition, the choice must be made based on the variables of each individual case.

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Paediatric small-bowel intussusception on ultrasound – a case report with differentiating features from the ileocolic subtype

Journal of Ultrasonography ◽

10.15557/jou.2021.0011 ◽

2021 ◽

Vol 21 (84) ◽

pp. e70-e73

Author(s):

Pushkar Mendiratta ◽

◽

Anurav Yadav ◽

Nitin Borse ◽

◽

...

Keyword(s):

Case Report ◽

Small Bowel ◽

Clinical Features ◽

Patient Management ◽

Ultrasound Examination ◽

Emergency Ultrasound ◽

Case Description ◽

Imaging Findings ◽

Paediatric Emergency ◽

Small Bowel Intussusception

Aim of the study: Intussusception is a common paediatric emergency which can be diagnosed with relative certainty by ultrasonography in trained hands. Both the ileocolic and small-bowel intussusception have overlapping clinical features and imaging findings on ultrasound. The aim is to differentiate between both subtypes based on selective differentiating features which should always be looked for while performing an ultrasound examination in suspected cases. Differentiating between the two subtypes is essential, since patient management may differ depending on the subtype. Case description: We present a case of a 12-year-old boy who presented to our hospital with pain in the abdomen. An emergency ultrasound revealed findings suggestive of small- bowel intussusception. A brief description of the differentiating points from the ileocolic subtype is also described. Conclusions: Based on the features described, it is possible to confidently differentiate between the two subtypes, which is a guiding factor for treatment.

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Coccidioidal Meningitis With Hyphal Forms Detected in Cerebrospinal Fluid in a Patient With Ventriculoperitoneal Shunt: A Case Report

Journal of Central Nervous System Disease ◽

10.1177/11795735211053446 ◽

2021 ◽

Vol 13 ◽

pp. 117957352110534

Author(s):

Jeremy Shi ◽

Myra Wong ◽

Ya Xu

Keyword(s):

Emergency Department ◽

Cerebrospinal Fluid ◽

Case Report ◽

Ventriculoperitoneal Shunt ◽

Altered Mental Status ◽

Coccidioides Immitis ◽

Coccidioides Posadasii ◽

Increased Risk ◽

Patient Reported ◽

Hispanic Male

Coccidioidomycosis is a fungal infection caused by Coccidioides immitis and Coccidioides posadasii. The most severe disseminated coccidioidomycosis results in meningoencephalitis. Literature review reveals very rare reports of hyphal forms of coccidioides organisms detected in CSF. We present a case of a 58-year-old Hispanic male with a 10-year persistence of CM and many ventriculoperitoneal shunt reversions. The patient initially presented with a hydrocephalus of unknown source. The diagnosis of CM was made three years later based on a culture. On this presentation at the emergency department (ED), the patient reported one day of worsening left-sided weakness, altered mental status, and vomiting. We detected the hyphal forms of coccidioides in the cerebrospinal fluid (CSF) during cytopathology examination. Awareness of this reversion from spherule form to hyphal form is helpful in diagnosis and treatment. The hyphal forms of coccidioides may be associated with the increased risk of obstruction of the shunts. It is important to submit CSF for cytopathology examination for diagnosis, especially in patients with shunts.

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