Iatrogenic failure of a ventriculoperitoneal shunt

1977 ◽  
Vol 46 (6) ◽  
pp. 830-831 ◽  
Author(s):  
Arthur M. Gerber
Keyword(s):  
Cerebrospinal Fluid ◽  
Ventriculoperitoneal Shunt ◽  
Hip Dislocation ◽  
Shunt Failure ◽  
Spica Cast ◽  
Congenital Hip Dislocation ◽  
Content Type ◽  
Cerebrospinal Fluid Flow ◽  
Flow Through ◽  
Fine Print

✓ A previously undescribed cause of ventriculoperitoneal shunt malfunction is presented. Limitation of abdominal excursion by a spica cast used to correct congenital hip dislocation reduced cerebrospinal fluid flow through a shunt. This easily correctable cause of “shunt failure” nearly resulted in replacement of a working shunt.

Audible cerebrospinal fluid flow through a ventriculoperitoneal shunt

1987 ◽  
Vol 67 (3) ◽  
pp. 460-462 ◽  
Author(s):  
Joe I. Ordia ◽  
Ronald W. Mortara ◽  
Edward L. Spatz
Keyword(s):  
Cerebrospinal Fluid ◽  
Fluid Flow ◽  
Ventriculoperitoneal Shunt ◽  
Content Type ◽  
Cerebrospinal Fluid Flow ◽  
Ventriculoperitoneal Shunting ◽  
Flow Through ◽  
Fine Print

✓ An audible, noisy cerebrospinal fluid flow is an uncommon sequela of ventriculoperitoneal shunting. Two cases presenting this phenomenon are described.

Management of proximal shunt obstruction

1988 ◽  
Vol 68 (5) ◽  
pp. 817-819 ◽  
Author(s):  
Charles C. Duncan
Keyword(s):  
Cerebrospinal Fluid ◽  
Fluid Flow ◽  
Intracranial Pressure ◽  
Signs And Symptoms ◽  
Ventricular Catheter ◽  
Shunt Failure ◽  
Content Type ◽  
Cerebrospinal Fluid Flow ◽  
Shunt Obstruction ◽  
Fine Print

✓ Proximal shunt obstruction or obstruction of the ventricular catheter may present with signs and symptoms of shunt failure with either no cerebrospinal fluid flow or a falsely low intracranial pressure (ICP) upon shunt tap. The author reports a technique for lowering the ICP and for measuring the pressure in patients with such obstruction by cannulation of the reservoir and ventricular catheter to penetrate into the ventricle with a 3½-in. No. 22 spinal needle. The findings in 20 cases in which this approach was utilized are summarized.

Pneumocephalus following ventriculoperitoneal shunt

1975 ◽  
Vol 43 (5) ◽  
pp. 631-633 ◽  
Author(s):  
Lawrence H. Pitts ◽  
Charles B. Wilson ◽  
Herbert H. Dedo ◽  
Robert Weyand
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Ventriculoperitoneal Shunt ◽  
Cerebrospinal Fluid Leakage ◽  
Congenital Defects ◽  
Content Type ◽  
Ventriculoperitoneal Shunting ◽  
Tegmen Tympani ◽  
Temporal Bones ◽  
Fine Print

✓ The authors describe a case of massive pneumocephalus following ventriculoperitoneal shunting for hydrocephalus. After multiple diagnostic and surgical procedures, congenital defects in the tegmen tympani of both temporal bones were identified as the sources for entry of air. A functioning shunt intermittently established negative intracranial pressure and allowed ingress of air through these abnormalities; when the shunt was occluded, air did not enter the skull, and there was no cerebrospinal fluid leakage. Repair of these middle ear defects prevented further recurrence of pneumocephalus.

Abdominal pseudocysts and ascites formation after ventriculoperitoneal shunt procedures

1975 ◽  
Vol 43 (4) ◽  
pp. 476-480 ◽  
Author(s):  
S. Walton Parry ◽  
John F. Schuhmacher ◽  
Raeburn C. Llewellyn
Keyword(s):  
Cerebrospinal Fluid ◽  
Ventriculoperitoneal Shunt ◽  
Signs And Symptoms ◽  
Late Complications ◽  
Neurological Symptoms ◽  
Shunt Malfunction ◽  
Content Type ◽  
Ventriculoperitoneal Shunts ◽  
Ascites Formation ◽  
Fine Print

✓The authors report three patients with abdominal pseudocysts and one with cerebrospinal fluid ascites as late complications of ventriculoperitoneal shunts. The presenting signs and symptoms were those of an intraabdominal abnormality, with no neurological symptoms suggestive of shunt malfunction.

Primary spinal syringomyelia

2005 ◽  
Vol 3 (6) ◽  
pp. 429-435 ◽  
Author(s):  
Ulrich Batzdorf
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Fluid Flow ◽  
Craniovertebral Junction ◽  
Arachnoid Cysts ◽  
Spinal Cord Tumors ◽  
Content Type ◽  
Cerebrospinal Fluid Flow ◽  
Different Types ◽  
Fine Print

✓ In the present review the author describes the different types of syringomyelia that originate from abnormalities at the level of the spinal cord rather than at the craniovertebral junction. These include posttraumatic and postinflammatory syringomyelia, as well as syringomyelia associated with arachnoid cysts and spinal cord tumors. The diagnosis and the principles of managing these lesions are discussed, notably resection of the entity restricting cerebrospinal fluid flow. Placement of a shunt into the syrinx cavity is reserved for patients in whom other procedures have failed or who are not candidates for other procedures.

The significance of bacteriologically positive ventriculoperitoneal shunt components in the absence of other signs of shunt infection

1996 ◽  
Vol 84 (4) ◽  
pp. 617-623 ◽  
Author(s):  
Paul Steinbok ◽  
D. Douglas Cochrane ◽  
John R. W. Kestle
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Clinical Evidence ◽  
Shunt Infection ◽  
Shunt Failure ◽  
Coagulase Negative Staphylococci ◽  
Content Type ◽  
Bacteriological Culture ◽  
Time Period ◽  
Fine Print ◽  
Infecting Organisms

✓ The purpose of this study was to determine the significance of “asymptomatic bacteriological shunt contamination” (ABSC), defined as a positive bacteriological culture found on a ventricular shunt component in the absence of bacteria in the cerebrospinal fluid (CSF) culture and/or clinical evidence of infection. Of 174 ventriculoperitoneal shunt revisions, 19 cases of ABSC were identified and reviewed retrospectively. In all but one case, no antibiotic medications were instituted because of the positive bacteriological culture. The most common infecting organisms were coagulase-negative staphylococci (seven) and propionibacteria (eight). A comparison of the 19 study cases with the authors' overall shunt experience, as documented in the British Columbia's Children's Hospital shunt database for the time period of the study, lead the authors to suggest that ABSC was not of significance in causing the shunt failure at which contamination was identified and, more importantly, did not increase the risk of future shunt malfunction. The results of this study indicate that in the absence of clinical evidence of shunt infection or a positive bacteriological culture from CSF, bacteria in a shunt component removed at revision in a child almost always represents a contaminant that may be ignored. Therefore, the authors advise that routine culture of shunt components removed at revision of a shunt is not indicated.

Cerebrospinal fluid shunt colonization and obstruction by Paecilomyces variotii

1981 ◽  
Vol 54 (2) ◽  
pp. 257-260 ◽  
Author(s):  
Rodger Fagerburg ◽  
Byungse Shu ◽  
Helen R. Buckley ◽  
Bennett Lorber ◽  
John Karian
Keyword(s):  
Cerebrospinal Fluid ◽  
Ventriculoperitoneal Shunt ◽  
Cerebrospinal Fluid Shunt ◽  
Human Pathogen ◽  
Cardiac Valves ◽  
Paecilomyces Variotii ◽  
Content Type ◽  
Lens Implantation ◽  
Noncommunicating Hydrocephalus ◽  
Fine Print

✓ A 57-year-old woman underwent ventriculoperitoneal shunt placement for noncommunicating hydrocephalus. She required several shunt revisions over a 2-year period for recurrent hydrocephalus. The shunt was subsequently found to be obstructed by growth of the saprophytic fungus, Paecilomyces variotii, an infrequent human pathogen. Paecilomyces infections have caused complications associated with prosthetic cardiac valves and synthetic lens implantation; this is the first reported association with a cerebrospinal fluid shunt.

Ventriculoperitoneal shunt malfunction during pregnancy

1985 ◽  
Vol 63 (3) ◽  
pp. 459-460 ◽  
Author(s):  
Junya Hanakita ◽  
Takanori Suzuki ◽  
Yoshisuke Yamamoto ◽  
Yuji Kinuta ◽  
Kiyoshi Nishihara
Keyword(s):  
Cerebrospinal Fluid ◽  
Ventriculoperitoneal Shunt ◽  
Shunt Malfunction ◽  
Cerebrospinal Fluid Shunts ◽  
Shunt System ◽  
Content Type ◽  
Fine Print

✓ Malfunction of a ventriculoperitoneal shunt is reported in a 25-year-old woman at 32 weeks of gestation. Pregnancies and delivery in women with cerebrospinal fluid shunts are rarely reported, and malfunction of a shunt system during pregnancy is extremely unusual.

Hydrocephalus due to villous hypertrophy of the choroid plexus in the lateral ventricles

1994 ◽  
Vol 80 (2) ◽  
pp. 321-323 ◽  
Author(s):  
Hirofumi Hirano ◽  
Kazuho Hirahara ◽  
Tetsuhiko Asakura ◽  
Tetsuro Shimozuru ◽  
Koki Kadota ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Mental Retardation ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Choroid Plexus ◽  
Ventriculoperitoneal Shunt ◽  
Rare Case ◽  
Content Type ◽  
Lateral Ventricles ◽  
Fine Print

✓ A case is reported of hydrocephalus due to overproduction of cerebrospinal fluid (CSF) caused by villous hypertrophy of the choroid plexus in the lateral ventricles. A 7-year-old girl with mental retardation developed gait disturbance; hydrocephalus and a Dandy-Walker cyst were detected on computerized tomography. She was initially treated with a ventriculoperitoneal shunt; however, shunting failed to control the hydrocephalus. The excessive outflow of CSF suggested choroid plexus abnormality, and magnetic resonance (MR) imaging revealed enlargement of the choroid plexus in both lateral ventricles. The patient was therefore diagnosed as having hydrocephalus induced by overproduction of CSF, which was controlled by resection of the choroid plexus. Histological examination showed the structure typical of normal choroid plexus. This is a rare case of villous hypertrophy of the choroid plexus in which MR imaging assisted in the diagnosis.

External hydrocephalus in adults

1996 ◽  
Vol 85 (6) ◽  
pp. 1143-1147 ◽  
Author(s):  
érico R. Cardoso ◽  
Romaine Schubert
Keyword(s):  
Cerebrospinal Fluid ◽  
Ventriculoperitoneal Shunt ◽  
Animal Experiments ◽  
Great Resistance ◽  
Posthemorrhagic Hydrocephalus ◽  
Content Type ◽  
External Hydrocephalus ◽  
Csf Shunting ◽  
Fluid Collections ◽  
Fine Print

✓ The authors report three adult patients who developed a symptomatic extraaxial collection of cerebrospinal fluid (CSF) after an intracranial hemorrhage. The fluid shifted from the extraaxial into the ventricular space as the patients' symptoms progressed. The symptoms resolved after placement of a ventriculoperitoneal shunt. External hydrocephalus, which is frequently observed in children, had not yet been described in adults. It is important to differentiate chronic subdural collections from external hydrocephalus, because ventricular CSF shunting increases the former while it is the treatment for the latter. The authors believe that symptomatic extraaxial fluid collections developed in these three adults during the early phase of posthemorrhagic hydrocephalus because the ventricles presented great resistance to distention at the onset of hydrocephalus. Animal experiments have led to the same result.

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