Delayed intracerebellar hemorrhage secondary to lumboperitoneal shunt insertion

Background: Early shunt obstruction (SO) remains the most common cause of lumboperitoneal shunt (LPS) failure. Although there is anecdotal evidence that the level of cerebrospinal fluid (CSF) parameters might affect shunt performance, its association with early LPS obstruction in adults with post-hemorrhagic hydrocephalus (PHH) is unclear.Methods: The retrospective study was performed by reviewing the adults with PHH treated by LPS from years 2014 to 2018. We included patients with CSF samples analyzed within 1 week prior to shunt insertion or at the time of shunt insertion. Baseline characteristics of each patient were collected. The primary outcomes were the incidence rate and associated factors of SO occurring within 3 months of shunt placement. The secondary outcomes included scores on the National Institute of Health Stroke Scale (NIHSS) and Evans Index at discharge.Results: A total of 76 eligible patients were analyzed, of whom 61 were obstruction-free and 15 were early SO. The overall rate of early SO was 15.6%. The RBCs count and nucleated cells count in preoperative CSF were actually higher in patients with early SO, compared to patients in the control group. Multivariate analysis identified RBC elevation (>0 × 106/L; OR: 10.629, 95% CI: 1.238–91.224, p = 0.031) as a dependent risk factor for early SO. NIHSS dramatically decreased at discharge while the alteration of ventricular size was not observed.Conclusions: This study suggested that the presence of RBCs in preoperative CSF was associated with early SO in patients with PHH treated by LPS.

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Lumboperitoneal shunt placement using computed tomography and fluoroscopy in conscious patients

Journal of Neurosurgery ◽

10.3171/2009.1.jns08204 ◽

2009 ◽

Vol 111 (3) ◽

pp. 618-622 ◽

Cited By ~ 4

Author(s):

Madoka Nakajima ◽

Kuniaki Bando ◽

Masakazu Miyajima ◽

Hajime Arai

Keyword(s):

Outpatient Surgery ◽

Guide Wire ◽

Operating Time ◽

Normal Pressure ◽

Shunt Valve ◽

Shunt Insertion ◽

Shunt Placement ◽

Lumboperitoneal Shunt ◽

Lower Limb Pain ◽

Programmable Valve

The authors have developed a minimally invasive lumboperitoneal shunt placement procedure conducted after administration of a local anesthetic. The procedure involves placing a guide wire and a peel-away sheath under fluoroscopic and CT guidance. Between June 2004 and August 2006, 40 patients (21 men and 19 women; mean age 72.5 years [range 33–86 years]) underwent surgery. A Codman Hakim programmable valve system (82–3844, Codman & Shurtleff, Inc.) was used for the procedure. The mean operating time was 53 minutes, and 7 patients (17.5%) developed shunt dysfunction complications. These complications comprised an infected shunt valve in 2 patients, postoperative lower-limb pain in 1 patient, and shunt obstruction (caused by debris and hemorrhage) at the ventral and lumbar ends in 2 patients each. This procedure is less invasive than conventional lumboperitoneal shunt insertion and could be performed as an outpatient surgery for treatment of idiopathic normal-pressure hydrocephalus.

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Intracerebral hematoma following lumboperitoneal shunt insertion: a rare case report

Turkish Neurosurgery ◽

10.5137/1019-5149.jtn.2131-09.3 ◽

2009 ◽

Author(s):

Turkoglu Erhan ◽

Kazanci Burak ◽

Karavelioglu Ergun ◽

Sanli Metin ◽

Kazanci Burcu ◽

...

Keyword(s):

Case Report ◽

Rare Case ◽

Intracerebral Hematoma ◽

Shunt Insertion ◽

Lumboperitoneal Shunt ◽

Rare Case Report

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Pre-operative assessment of ventricular size and ventricle-to-hemisphere area ratio permits estimation of the need for ventriculo-peritoneal shunt insertion during the first three months of postnatal life in fetuses before fetoscopic surgery for spina bifida aperta

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-0033-1355069 ◽

2013 ◽

Vol 34 (S 01) ◽

Author(s):

J Degenhardt ◽

A Khaleeva ◽

C Enzensberger ◽

R Axt-Fliedner ◽

T Kohl

Keyword(s):

Spina Bifida ◽

Area Ratio ◽

Postnatal Life ◽

Ventricular Size ◽

Shunt Insertion ◽

Spina Bifida Aperta ◽

Operative Assessment ◽

Ventriculo Peritoneal Shunt

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Effect of Fixed Node Maneuver on Migration of Lumboperitoneal Shunt: A pilot study

International Journal of Medical Arts ◽

10.21608/ijma.2020.20340.1049 ◽

2020 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

Mohammed Ahmed Alhady ◽

Mohamed Mansour ◽

Hatem Elkhouly

Keyword(s):

Pilot Study ◽

Lumboperitoneal Shunt ◽

Fixed Node

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Post-haemorrhagic hydrocephalus is associated with poorer surgical and neurodevelopmental sequelae than other causes of infant hydrocephalus

Child s Nervous System ◽

10.1007/s00381-021-05226-4 ◽

2021 ◽

Author(s):

Malak Mohamed ◽

Saniya Mediratta ◽

Aswin Chari ◽

Cristine Sortica da Costa ◽

Greg James ◽

...

Keyword(s):

Gestational Age ◽

Cox Regression ◽

Severe Disabilities ◽

Median Number ◽

Shunt Revision ◽

Endocrine Dysfunction ◽

Neurodevelopmental Outcomes ◽

Shunt Insertion ◽

Street Hospital ◽

Shunt Survival

Abstract Purpose This retrospective cohort study aimed to investigate the surgical and neurodevelopmental outcomes (NDO) of infant hydrocephalus. We also sought to determine whether these outcomes are disproportionately poorer in post-haemorrhagic hydrocephalus (PHH) compared to other causes of infant hydrocephalus. Methods A review of all infants with hydrocephalus who had ventriculoperitoneal (VP) shunts inserted at Great Ormond Street Hospital (GOSH) from 2008 to 2018 was performed. Demographic, surgical, neurodevelopmental, and other clinical data extracted from electronic patient notes were analysed by aetiology. Shunt survival, NDO, cerebral palsy (CP), epilepsy, speech delay, education, behavioural disorders, endocrine dysfunction, and mortality were evaluated. Results A total of 323 infants with median gestational age of 37.0 (23.29–42.14) weeks and birthweight of 2640 g (525–4684 g) were evaluated. PHH was the most common aetiology (31.9%) and was associated with significantly higher 5-year shunt revision rates, revisions beyond a year, and median number of revisions than congenital or “other” hydrocephalus (all p < 0.02). Cox regression demonstrated poorest shunt survival in PHH, related to gestational age at birth and corrected age at shunt insertion. PHH also had the highest rate of severe disabilities, increasing with age to 65.0% at 10 years, as well as the highest CP rate; only genetic hydrocephalus had significantly higher endocrine dysfunction (p = 0.01) and mortality rates (p = 0.04). Conclusions Infants with PHH have poorer surgical and NDO compared to all other aetiologies, except genetic hydrocephalus. Research into measures of reducing neurodisability following PHH is urgently required. Long-term follow-up is essential to optimise support and outcomes.

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