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.

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.

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.

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.

Analysis of the cerebrospinal fluid pulse wave in intracranial pressure

1983 ◽  
Vol 59 (5) ◽  
pp. 817-821 ◽  
Author(s):  
Erico R. Cardoso ◽  
Jack O. Rowan ◽  
Sam Galbraith
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Pulse Wave ◽  
Cerebrovascular Reactivity ◽  
Ventricular Catheter ◽  
Benign Intracranial Hypertension ◽  
Content Type ◽  
Voluntary Hyperventilation ◽  
Head Elevation ◽  
Fine Print

✓ The configuration of the intracranial pressure (ICP) pulse wave represents a complex sum of various components. Amplitude variations of an isolated component might reflect changes in a specific intracranial structure. Fifteen awake patients suffering from hydrocephalus, benign intracranial hypertension, or head injury underwent ICP monitoring through a ventricular catheter and were subjected to three standardized maneuvers to alter the intracranial dynamics: head elevation, voluntary hyperventilation, and cerebrospinal fluid (CSF) withdrawal. A 12° head elevation and fractionated CSF withdrawal caused a mild ICP drop and a proportionate amplitude reduction of all the wave components. Voluntary hyperventilation caused a comparable fall in ICP, and a disproportionate reduction in the amplitude of the wave components, especially the P2 component. It is postulated that the decrease in amplitude of the P2 component reflects the reduction of the cerebral bulk caused by hyperventilation. Head elevation and CSF withdrawal caused a decrease of global ICP but no specific changes in any intracranial structure, and consequently the configuration of the pulse wave remained unchanged. The establishment of relationships between anatomical substrate and particular wave components is promising since potentially it could be useful for monitoring conditions such as vasoparalysis, impaired cerebrovascular reactivity, and cerebral edema.

A clinical comparison of subdural screw pressure measurements with ventricular pressure

1983 ◽  
Vol 58 (1) ◽  
pp. 45-50 ◽  
Author(s):  
A. David Mendelow ◽  
John O. Rowan ◽  
Lilian Murray ◽  
Audrey E. Kerr
Keyword(s):  
Head Injury ◽  
Intracranial Pressure ◽  
Severe Head Injury ◽  
Fluid Pressure ◽  
Ventricular Catheter ◽  
Pressure Measurements ◽  
Content Type ◽  
Single Lumen ◽  
Ventricular Fluid Pressure ◽  
Fine Print

✓ Simultaneous recordings of intracranial pressure (ICP) from a single-lumen subdural screw and a ventricular catheter were compared in 10 patients with severe head injury. Forty-one percent of the readings corresponded within the same 10 mm Hg ranges, while 13% of the screw pressure measurements were higher and 46% were lower than the associated ventricular catheter measurements. In 10 other patients, also with severe head injury, pressure measurements obtained with the Leeds-type screw were similarly compared with ventricular fluid pressure. Fifty-eight percent of the dual pressure readings corresponded, while 15% of the screw measurements were higher and 27% were lower than the ventricular fluid pressure, within 10-mm Hg ranges. It is concluded that subdural screws may give unreliable results, particularly by underestimating the occurrence of high ICP.

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.

Mumps as a Cause of Hydrocephalus

PEDIATRICS ◽  
1972 ◽  
Vol 50 (2) ◽  
pp. 346-347
Author(s):  
J. Hower ◽  
H. E. Clar ◽  
M. Düchting
Keyword(s):  
Cerebrospinal Fluid ◽  
Fluid Flow ◽  
Intracranial Pressure ◽  
Head Circumference ◽  
Aqueductal Stenosis ◽  
Sudden Increase ◽  
Increased Intracranial Pressure ◽  
Cerebrospinal Fluid Flow ◽  
Human Pathology ◽  
Experimental Findings

We read Dr. Bray's communication with great interest. With actually three cases of aqueductal stenosis after mumps being recorded we cannot doubt that the experimental findings of Johnson and Johnson have a bearing on human pathology. Our patient, a 6½-year-old boy, underwent evaluation of his megacephalus five months before the onset of mumps. At that time a pneumoencephalogram could be obtained by lumbar filling. Cerebrospinal fluid flow was considered marginally adequate. Three months after mumps meningoencephalitis the patient presented with symptoms of increased intracranial pressure (papilledema, sudden increase in head circumference, and widening of the coronar suture).

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