BACKGROUND Intra-gastric migration of the distal ventriculoperitoneal shunt(VPS)catheter clinically presenting with or without trans-oral extrusion is one of the rare complications of VPS catheter insertion.AIM To ide...BACKGROUND Intra-gastric migration of the distal ventriculoperitoneal shunt(VPS)catheter clinically presenting with or without trans-oral extrusion is one of the rare complications of VPS catheter insertion.AIM To identify the demographics,clinical presentation,clinical findings,and results of surgical therapy offered for the treatment of intra-gastric migration of the distal VPS catheter,clinically presented with or without trans-oral extrusion.METHODS An online search was performed for the extraction/retrieval of the published/available literature pertaining to the above-mentioned VPS complication.Manuscripts were searched from PubMed,PMC(PubMed Central),ResearchGate,and Google Scholar databases using various terminology relating to the VPS complications.The first case of migration of a VPS catheter into the stomach was reported in the year 1980,and the data were retrieved from 1980 to December 2022.Cases were categorized into two groups;Group A:Cases who had migration of the distal VPS catheter into the stomach and clinically presented with trans-oral extrusion of the same,and Group B:Cases who had migration of the distal VPS catheter into the stomach,but presented without trans-oral extrusion.RESULTS A total of n=46 cases(n=27;58.69%male,and n=19;41.3%females)were recruited for the systematic review.Group A included n=32,and Group B n=14 cases.Congenital hydrocephalus was the indication for the primary VPS insertion for approximately half of the(n=22)cases.Approximately sixty percent(n=27)of them were children≤5 years of age at the time of the diagnosis of the complication mentioned above.In seventy-two percent(n=33)cases,this complication was detected within 24 mo after the VPS insertion/last shunt revision.Clinical diagnosis was evident for the entire group A cases.Various diagnostic modalities were used to confirm the diagnosis for Group B cases.Various surgical procedures were offered for the management of the complication in n=43 cases of both Groups.In two instances,intra-gastric migration of the distal VPS catheter was detected during the autopsy.This review documented four deaths.CONCLUSION Intra-gastric migration of the peritoneal end of a VPS catheter is one of the rare complications of VPS catheter implantation done for the treatment of hydrocephalus across all age groups.It was more frequently reported in children,although also reported in adults and older people.A very high degree of clinical suspicion is required for the diagnosis of a case of an intra-gastric migration of the distal VPS catheter clinically presenting without transoral extrusion.展开更多
An abdominal cerebrospinal fluid pseudocyst is a rare complication of ventriculoperitoneal shunt. Several theories have been suggested to explain its occurrence. The main symptoms are painful abdominal distension and ...An abdominal cerebrospinal fluid pseudocyst is a rare complication of ventriculoperitoneal shunt. Several theories have been suggested to explain its occurrence. The main symptoms are painful abdominal distension and vomiting, abdominal distension on examination, as abdominal ultrasound and computed tomography confirm its diagnosis. The treatment involves drainage associated with drain relocation and resection of the pseudocyst’s wall. We report two patients diagnosed with this condition who underwent surgical treatment. The first patient had an unremarkable 12-month follow-up, while the second died on the seventh postoperative day due to intravascular disseminated coagulation. In these patients, the cause has not been identified;however, an infection cannot be ruled out.展开更多
BACKGROUND Delayed intracranial hemorrhage(DICH),a potential complication of ventriculoperitoneal(VP)shunts,has been associated with high mortality,but its risk factors are still unclear.AIM To investigate the risk fa...BACKGROUND Delayed intracranial hemorrhage(DICH),a potential complication of ventriculoperitoneal(VP)shunts,has been associated with high mortality,but its risk factors are still unclear.AIM To investigate the risk factors of DICH after VP shunts.METHODS We compared the demographic and clinical characteristics of DICH and non-DICH adult patients with VP shunts between January 2016 and December 2020.RESULTS The 159 adult VP shunt patients were divided into 2 groups according to the development of DICH:the DICH group(n=26)and the non-DICH group(n=133).No statistically significant difference was found in age,sex,laboratory examination characteristics or preoperative modified Rankin Scale(mRS)score between the DICH and non-DICH groups(P>0.05);however,a history of an external ventricular drain(EVD)[P=0.045;odds ratio(OR):2.814;95%CI:1.024-7.730]and postoperative brain edema around the catheter(P<0.01;OR:8.397;95%CI:3.043-23.171)were associated with a high risk of DICH.A comparison of preoperative mRS scores between the DICH group and the non-DICH group showed no significant difference(P=0.553),while a significant difference was found in the postoperative mRS scores at the 3-mo follow-up visit(P=0.024).CONCLUSION A history of EVD and postoperative brain edema around the catheter are independent risk factors for DICH in VP shunt patients.DICH patients with a high mRS score are vulnerable to poor clinical outcomes.展开更多
We are describing a case of a female infant with ventriculoperitoneal shunt scheduled for inguinal hernia repair under spinal anesthesia. The child was a premature newborn who, in a recent past, underwent surgery in g...We are describing a case of a female infant with ventriculoperitoneal shunt scheduled for inguinal hernia repair under spinal anesthesia. The child was a premature newborn who, in a recent past, underwent surgery in general anesthesia for retinopathy correction with subsequent difficult mechanical ventilation weaning. The benefit of spinal anesthesia in high-risk infant was described and the risks of spinal anesthesia in the presence of a ventricular shunt device-especially dural leakage and infections were briefly discussed.展开更多
Traumatic acute subdural hematoma is one of the most lethal causes of head injuries,which leads to high mortality.While combined diseases always make it more intractable for the treatment.We present a case of a 68-yea...Traumatic acute subdural hematoma is one of the most lethal causes of head injuries,which leads to high mortality.While combined diseases always make it more intractable for the treatment.We present a case of a 68-year-old female patient with traumatic acute subdural hematoma combined with hydrocephalus after ventriculoperitoneal shunt assisted by the neuronavigation system in January 12,2017.She was undergone ventriculoperitoneal shunt 6 years and 5 months ago on two sides respectively because of hydrocephalus,with the ventriculoperitoneal shunt device on the right side out of work.The initial neurological examination showed a Glasgow Coma Scale of E2V1M5 with no papillary defect.A CT scan of the head revealed a left homogeneously hyperdense and subdural hematoma,with compression of the lateral ventricle(2.6 cm thick)and a 0.5 cm midline shift.To protect the ventriculoperitoneal shunt device,we used neuronavigation system to precisely mark the relative location of the device and“invisible”subdural hematoma,thus to design a perfect incision preoperatively.Subsequently,evacuation of the subdural hematoma was performed via craniotomy without damaging the ventriculoperitoneal shunt device.Postoperative CT of the head showed totally removing of the subdural hematoma.The patient recovered three months later.With the assistant of neuronavigation system,it is much easier for the preoperative planning and to reduce the surgical risk.Our case gives a clue that more approaches can be considered when encountering acute head trauma with the complicated combined diseases.展开更多
Objective:To analyze the effect of ventriculoperitoneal shunt on the recovery of brain function in children with hydrocephalus.Methods:The clinical data of 40 children with hydrocephalus were retrospectively analyzed....Objective:To analyze the effect of ventriculoperitoneal shunt on the recovery of brain function in children with hydrocephalus.Methods:The clinical data of 40 children with hydrocephalus were retrospectively analyzed.Ventriculoperitoneal shunt was performed with 9003 shunt tube and P.S.Shunt tube,B.C.E.shunt tube.Electroencephalogram(EEG),and brain CT/MRI were performed before and after surgery,and postoperative follow-up was carried out to observe the therapeutic effect.Results:In this study,there were seven cases of intracranial injury,seven cases of congenital hydrocephalus,11 cases of ventricular end obstruction,three cases of abdominal end obstruction,nine cases complicated with bacterial infection,and 3 cases of shunt entering the scrotum.The prognosis of all the children was good,and there were no significant changes in eight cases.Conclusion:Ventriculoperitoneal shunt is effective in the treatment of children with hydrocephalus.展开更多
<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:;" "=""><span style="font-family:Verdana;"> The ven...<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:;" "=""><span style="font-family:Verdana;"> The ventriculoperitoneal (VPS) shunt is the most common procedure in the treatment of hydrocephalus in children. Abdominal cerebrospinal fluid pseudocysts are a rare complication of the ventriculoperitoneal shunt with an incidence ranging from less than 1% to 10% and are more prevalent in children. The malfunction of the ventriculoperitoneal shunt can cause headaches, nausea, vomiting, altered level of consciousness and abdominal pain due to the accumulation of cerebrospinal fluid. There is no consensus on which type of treatment is better in this case, but there are several available methods. </span><b><span style="font-family:Verdana;">Aim:</span></b> </span><span style="font-family:Verdana;">To </span><span style="font-family:;" "=""><span style="font-family:Verdana;">report an unusual case of a giant abdominal cerebrospinal fluid pseudocyst as a complication of the VPS. </span><b><span style="font-family:Verdana;">Case Presentation:</span></b><span style="font-family:Verdana;"> Female 1</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">y/3</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">m</span><span style="font-family:Verdana;">on</span><span style="font-family:;" "=""><span style="font-family:Verdana;">ths old patient, less than 7 kg, that has been diagnosed with hydrocephalus prenatally, confirmed postnatally associated with an esophageal atresia and distal tracheoesophageal fistula (AE/FTE, Gross III), was admitted to our service with progressive abdominal distention without obstructive intestinal signs or peritoneal inflammatory signs. The CT scan of the abdomen showed a large liquid collection (estimated volume of 600 ml), centered on the umbilical region, diagnosed as a giant abdominal cerebrospinal fluid (CSF) pseudocyst from the VPS. All of data and information were obtained from her medical records at the infirmary of the Conjunto Hospitalar de Sorocaba (CHS), S<span style="white-space:nowrap;">ã</span>o Paulo. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Abdominal CSF as a cause of th</span></span><span style="font-family:Verdana;">ese</span><span style="font-family:Verdana;"> giant pseudocysts should be considered as a diagnostic hypothesis for cases of large abdominal distensions without intestinal involvement in patients with a VPS. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</span>展开更多
Objective To explore a new approach for improving therapeutic effects and minimizing complications of ventriculoperitoneal shunt(VPS) . Methods The lengthof and lower edge of the greater omentum were measured and anal...Objective To explore a new approach for improving therapeutic effects and minimizing complications of ventriculoperitoneal shunt(VPS) . Methods The lengthof and lower edge of the greater omentum were measured and analyzed in 28 autopsies (16 adults and 12 children) and laparoscopic surgeries. 95 cases of hydrocephalus treated by MIVPS(minimally invasive ventriculoperitoneal shunt) were retrospectively reviewed. The depth and positions展开更多
Objective To discuss the mechanism,clinical features,complications,diagnosis criteria and treatment of intracardiac migration of the distal catheter of ventriculoperitoneal shunt. Methods The diagnosis criteria and tr...Objective To discuss the mechanism,clinical features,complications,diagnosis criteria and treatment of intracardiac migration of the distal catheter of ventriculoperitoneal shunt. Methods The diagnosis criteria and treatment of 2 cases of intracardiac migration of the distal catheter of展开更多
Introduction: Pseudotumorcerebri(PTC) is a condition characterized by false brain tumor symptoms, caused by high intracranial pressure (ICP). Treatment options include medication, weight loss, surgery, and shunting. S...Introduction: Pseudotumorcerebri(PTC) is a condition characterized by false brain tumor symptoms, caused by high intracranial pressure (ICP). Treatment options include medication, weight loss, surgery, and shunting. Shunting, either ventriculoperitoneal (VP) or lumboperitoneal (LP), emerged as the preferred method of treatment, but there is an ongoing debate as to which technique should be prioritized. The aim of this study is to gather additional evidence to determine the optimal type of shunt for treating PTC. Materials and Methods: Ninety patients with PTC were studied at Damascus University between 2016 and 2021. The study monitored symptoms before and after treatment, with improvement related to the technique used (VP or LP shunts). Of all patients, 83 were women and 7 were men. In addition, complications were analyzed. Results: Both shunts showed similar postoperative rates of symptom improvement, but VP shunts were utilized more frequently overall in this study. Patients who received LP shunt surgery had a higher rate of postoperative complications compared to those who received VP shunt surgery, but the chi-squared analysis did not provide sufficient evidence to confirm a significant relationship between the type of surgery and the occurrence of postoperative complications. Conclusion: Despite ongoing controversy about the optimal treatment for benign intracranial hypertension (BTC), most authors approved the trend of using VP (ventriculoperitoneal) shunts, given a lower rate of complications. However, there is no statistically significant difference between outcomes of VP and LP (lumboperitoneal) shunting techniques, according to our research.展开更多
BACKGROUND Dandy-Walker malformation(DWM)was first reported in 1914.In this case report,a pediatric case was complicated with giant and isolated arachnoid cysts in the right cerebellar hemisphere along with the typica...BACKGROUND Dandy-Walker malformation(DWM)was first reported in 1914.In this case report,a pediatric case was complicated with giant and isolated arachnoid cysts in the right cerebellar hemisphere along with the typical DWM.CASE SUMMARY The patient was at 20 mo old boy,with the complaint of staggering for more than 2 mo.He was admitted to the hospital due to high intracranial pressure and staggering.At admission,the patient had typical manifestations of high intracranial pressure,including vomiting,poor appetite and feeding difficulty.Physical examination revealed increased head circumference,closed anterior fontanelle,unstable standing,staggering,leaning right while walking and ataxia.After admission,he was diagnosed with DWM accompanied by giant isolated arachnoid cysts in the posterior fossa.He underwent Y-shaped three-way valve repair for treating differential pressure between the supratentorial hydrocephalus and the subtentorial arachnoid cysts at once.The child recovered well after the surgery.CONCLUSION In this case,supratentorial and subtentorial shunts were placed,which solved the problem of differential pressure between the supratentorial and subtentorial parts simultaneously.This provides useful information regarding treatment exploration in this rare disease.展开更多
BACKGROUND The common treatment for hydrocephalus is insertion of a ventriculoperitoneal shunt.Shunt tube displacement is one of the common complications.Most shunt tube displacements occur in children and has a repor...BACKGROUND The common treatment for hydrocephalus is insertion of a ventriculoperitoneal shunt.Shunt tube displacement is one of the common complications.Most shunt tube displacements occur in children and has a reportedly lower incidence in adults.CASE SUMMARY This study reports an adult patient(male,56 years)who suffered from intracranial aneurysm and subarachnoid hemorrhage and underwent aneurysm clipping following hospitalization.One month post onset of the disease,the patient underwent ventriculoperitoneal shunt due to hydrocephalus.The peritoneal end of the shunt tube was displaced in the peritoneal cavity 9 years after the aneurysm clipping.The peritoneal end of the shunt tube was removed and ventriculoperitoneal shunt was re-performed after anti-inflammatory treatment.CONCLUSION Shunt tube displacement has a low incidence in adults.In order to avoid shunt tube displacement,there is a need to summarize its causative factors and practice personalized medicine.展开更多
<b><span style="font-family:Verdana;">Object: </span></b><span style="font-family:""><span style="font-family:Verdana;">Incidence of Idiopathic ch...<b><span style="font-family:Verdana;">Object: </span></b><span style="font-family:""><span style="font-family:Verdana;">Incidence of Idiopathic chronic hydrocephalus of the adult (ICHA) is increasing in Guinea due to the aging of the population. The goal of this study was to describe its epidemiology, clinical presentation, and surgical outcome in a low-resource medical environment. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">Sixteen patients operated for a probable ICHA were prospectively studied according to a uniform protocol</span></span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">from June 2019 to December 2020. On computerized tomography, all operated patients had a clinical triad of gait disturbance, incontinence, dementia associated with ventriculomegaly, and transependymal edema. In addition, all patients underwent a single lumbar tap, improved clinically, and were subsequently offered a shunt consisting of a simple catheter in 37.5% and a non-adjustable high-pressure valve in 62.5%. </span><b><span style="font-family:Verdana;">Result: </span></b><span style="font-family:Verdana;">The mean age was 68.31 </span></span><span style="font-family:Verdana;">±</span><span style="font-family:""> </span><span style="font-family:Verdana;">10.4 (range 49</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">89). The sex ratio H/F was 1.67/1. Clinically, the most frequent comorbidity was a combination of hypertension and diabetes in 56.5% of cases.</span><span style="font-family:""> </span><span style="font-family:Verdana;">The mean time to diagnosis was 8.31 ± 2.75 months (range 3 - 14). The immediate postoperative mortality was 12.5% from a status epilepticus and pulmonary sepsis. In addition, we observed 2 cases of chronic subdural hematoma (12.5%) and 2 cases of shunt dysfunction</span><span style="font-family:""> </span><span style="font-family:Verdana;">(12.5%) in the first three months. The functional outcome was good in 23% of patients at one month (N</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">13), 50% at three months (N = 10), and 87.5% at six months (N = 8). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">In carefully selected cases, the surgical outcome of ICHA in Guinea </span></span><span style="font-family:Verdana;">is</span><span style="font-family:Verdana;"> comparable to high-income countries. Efforts need to be put in helping patients get covered with universal insurance and generally promote Neurosurgery in the country to improve the quality of care.展开更多
文摘BACKGROUND Intra-gastric migration of the distal ventriculoperitoneal shunt(VPS)catheter clinically presenting with or without trans-oral extrusion is one of the rare complications of VPS catheter insertion.AIM To identify the demographics,clinical presentation,clinical findings,and results of surgical therapy offered for the treatment of intra-gastric migration of the distal VPS catheter,clinically presented with or without trans-oral extrusion.METHODS An online search was performed for the extraction/retrieval of the published/available literature pertaining to the above-mentioned VPS complication.Manuscripts were searched from PubMed,PMC(PubMed Central),ResearchGate,and Google Scholar databases using various terminology relating to the VPS complications.The first case of migration of a VPS catheter into the stomach was reported in the year 1980,and the data were retrieved from 1980 to December 2022.Cases were categorized into two groups;Group A:Cases who had migration of the distal VPS catheter into the stomach and clinically presented with trans-oral extrusion of the same,and Group B:Cases who had migration of the distal VPS catheter into the stomach,but presented without trans-oral extrusion.RESULTS A total of n=46 cases(n=27;58.69%male,and n=19;41.3%females)were recruited for the systematic review.Group A included n=32,and Group B n=14 cases.Congenital hydrocephalus was the indication for the primary VPS insertion for approximately half of the(n=22)cases.Approximately sixty percent(n=27)of them were children≤5 years of age at the time of the diagnosis of the complication mentioned above.In seventy-two percent(n=33)cases,this complication was detected within 24 mo after the VPS insertion/last shunt revision.Clinical diagnosis was evident for the entire group A cases.Various diagnostic modalities were used to confirm the diagnosis for Group B cases.Various surgical procedures were offered for the management of the complication in n=43 cases of both Groups.In two instances,intra-gastric migration of the distal VPS catheter was detected during the autopsy.This review documented four deaths.CONCLUSION Intra-gastric migration of the peritoneal end of a VPS catheter is one of the rare complications of VPS catheter implantation done for the treatment of hydrocephalus across all age groups.It was more frequently reported in children,although also reported in adults and older people.A very high degree of clinical suspicion is required for the diagnosis of a case of an intra-gastric migration of the distal VPS catheter clinically presenting without transoral extrusion.
文摘An abdominal cerebrospinal fluid pseudocyst is a rare complication of ventriculoperitoneal shunt. Several theories have been suggested to explain its occurrence. The main symptoms are painful abdominal distension and vomiting, abdominal distension on examination, as abdominal ultrasound and computed tomography confirm its diagnosis. The treatment involves drainage associated with drain relocation and resection of the pseudocyst’s wall. We report two patients diagnosed with this condition who underwent surgical treatment. The first patient had an unremarkable 12-month follow-up, while the second died on the seventh postoperative day due to intravascular disseminated coagulation. In these patients, the cause has not been identified;however, an infection cannot be ruled out.
基金Supported by Shantou Medical Healthcare Science and Technology Program,No.~([2019])70Natural Science Foundation of Guangdong Province of China,No. 2022A1515010407Guangdong Provincial Science and Technology Fund ("major special project+Task list") for high-level hospital construction,No. STKJ2021119
文摘BACKGROUND Delayed intracranial hemorrhage(DICH),a potential complication of ventriculoperitoneal(VP)shunts,has been associated with high mortality,but its risk factors are still unclear.AIM To investigate the risk factors of DICH after VP shunts.METHODS We compared the demographic and clinical characteristics of DICH and non-DICH adult patients with VP shunts between January 2016 and December 2020.RESULTS The 159 adult VP shunt patients were divided into 2 groups according to the development of DICH:the DICH group(n=26)and the non-DICH group(n=133).No statistically significant difference was found in age,sex,laboratory examination characteristics or preoperative modified Rankin Scale(mRS)score between the DICH and non-DICH groups(P>0.05);however,a history of an external ventricular drain(EVD)[P=0.045;odds ratio(OR):2.814;95%CI:1.024-7.730]and postoperative brain edema around the catheter(P<0.01;OR:8.397;95%CI:3.043-23.171)were associated with a high risk of DICH.A comparison of preoperative mRS scores between the DICH group and the non-DICH group showed no significant difference(P=0.553),while a significant difference was found in the postoperative mRS scores at the 3-mo follow-up visit(P=0.024).CONCLUSION A history of EVD and postoperative brain edema around the catheter are independent risk factors for DICH in VP shunt patients.DICH patients with a high mRS score are vulnerable to poor clinical outcomes.
文摘We are describing a case of a female infant with ventriculoperitoneal shunt scheduled for inguinal hernia repair under spinal anesthesia. The child was a premature newborn who, in a recent past, underwent surgery in general anesthesia for retinopathy correction with subsequent difficult mechanical ventilation weaning. The benefit of spinal anesthesia in high-risk infant was described and the risks of spinal anesthesia in the presence of a ventricular shunt device-especially dural leakage and infections were briefly discussed.
基金This work was supported by the Program for Health and Family Planning Commission of Hangzhou Municipality,China(2017A73)Medicine and Health Science and Technology Projects of Zhejiang Province,China(2018270408)+1 种基金National Natural Science Foundation of China(81402044)Natural Science Foundation of Zhejiang Province of China(LY14H160017,LY14H160025).
文摘Traumatic acute subdural hematoma is one of the most lethal causes of head injuries,which leads to high mortality.While combined diseases always make it more intractable for the treatment.We present a case of a 68-year-old female patient with traumatic acute subdural hematoma combined with hydrocephalus after ventriculoperitoneal shunt assisted by the neuronavigation system in January 12,2017.She was undergone ventriculoperitoneal shunt 6 years and 5 months ago on two sides respectively because of hydrocephalus,with the ventriculoperitoneal shunt device on the right side out of work.The initial neurological examination showed a Glasgow Coma Scale of E2V1M5 with no papillary defect.A CT scan of the head revealed a left homogeneously hyperdense and subdural hematoma,with compression of the lateral ventricle(2.6 cm thick)and a 0.5 cm midline shift.To protect the ventriculoperitoneal shunt device,we used neuronavigation system to precisely mark the relative location of the device and“invisible”subdural hematoma,thus to design a perfect incision preoperatively.Subsequently,evacuation of the subdural hematoma was performed via craniotomy without damaging the ventriculoperitoneal shunt device.Postoperative CT of the head showed totally removing of the subdural hematoma.The patient recovered three months later.With the assistant of neuronavigation system,it is much easier for the preoperative planning and to reduce the surgical risk.Our case gives a clue that more approaches can be considered when encountering acute head trauma with the complicated combined diseases.
文摘Objective:To analyze the effect of ventriculoperitoneal shunt on the recovery of brain function in children with hydrocephalus.Methods:The clinical data of 40 children with hydrocephalus were retrospectively analyzed.Ventriculoperitoneal shunt was performed with 9003 shunt tube and P.S.Shunt tube,B.C.E.shunt tube.Electroencephalogram(EEG),and brain CT/MRI were performed before and after surgery,and postoperative follow-up was carried out to observe the therapeutic effect.Results:In this study,there were seven cases of intracranial injury,seven cases of congenital hydrocephalus,11 cases of ventricular end obstruction,three cases of abdominal end obstruction,nine cases complicated with bacterial infection,and 3 cases of shunt entering the scrotum.The prognosis of all the children was good,and there were no significant changes in eight cases.Conclusion:Ventriculoperitoneal shunt is effective in the treatment of children with hydrocephalus.
文摘<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:;" "=""><span style="font-family:Verdana;"> The ventriculoperitoneal (VPS) shunt is the most common procedure in the treatment of hydrocephalus in children. Abdominal cerebrospinal fluid pseudocysts are a rare complication of the ventriculoperitoneal shunt with an incidence ranging from less than 1% to 10% and are more prevalent in children. The malfunction of the ventriculoperitoneal shunt can cause headaches, nausea, vomiting, altered level of consciousness and abdominal pain due to the accumulation of cerebrospinal fluid. There is no consensus on which type of treatment is better in this case, but there are several available methods. </span><b><span style="font-family:Verdana;">Aim:</span></b> </span><span style="font-family:Verdana;">To </span><span style="font-family:;" "=""><span style="font-family:Verdana;">report an unusual case of a giant abdominal cerebrospinal fluid pseudocyst as a complication of the VPS. </span><b><span style="font-family:Verdana;">Case Presentation:</span></b><span style="font-family:Verdana;"> Female 1</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">y/3</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">m</span><span style="font-family:Verdana;">on</span><span style="font-family:;" "=""><span style="font-family:Verdana;">ths old patient, less than 7 kg, that has been diagnosed with hydrocephalus prenatally, confirmed postnatally associated with an esophageal atresia and distal tracheoesophageal fistula (AE/FTE, Gross III), was admitted to our service with progressive abdominal distention without obstructive intestinal signs or peritoneal inflammatory signs. The CT scan of the abdomen showed a large liquid collection (estimated volume of 600 ml), centered on the umbilical region, diagnosed as a giant abdominal cerebrospinal fluid (CSF) pseudocyst from the VPS. All of data and information were obtained from her medical records at the infirmary of the Conjunto Hospitalar de Sorocaba (CHS), S<span style="white-space:nowrap;">ã</span>o Paulo. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Abdominal CSF as a cause of th</span></span><span style="font-family:Verdana;">ese</span><span style="font-family:Verdana;"> giant pseudocysts should be considered as a diagnostic hypothesis for cases of large abdominal distensions without intestinal involvement in patients with a VPS. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</span>
文摘Objective To explore a new approach for improving therapeutic effects and minimizing complications of ventriculoperitoneal shunt(VPS) . Methods The lengthof and lower edge of the greater omentum were measured and analyzed in 28 autopsies (16 adults and 12 children) and laparoscopic surgeries. 95 cases of hydrocephalus treated by MIVPS(minimally invasive ventriculoperitoneal shunt) were retrospectively reviewed. The depth and positions
文摘Objective To discuss the mechanism,clinical features,complications,diagnosis criteria and treatment of intracardiac migration of the distal catheter of ventriculoperitoneal shunt. Methods The diagnosis criteria and treatment of 2 cases of intracardiac migration of the distal catheter of
文摘Introduction: Pseudotumorcerebri(PTC) is a condition characterized by false brain tumor symptoms, caused by high intracranial pressure (ICP). Treatment options include medication, weight loss, surgery, and shunting. Shunting, either ventriculoperitoneal (VP) or lumboperitoneal (LP), emerged as the preferred method of treatment, but there is an ongoing debate as to which technique should be prioritized. The aim of this study is to gather additional evidence to determine the optimal type of shunt for treating PTC. Materials and Methods: Ninety patients with PTC were studied at Damascus University between 2016 and 2021. The study monitored symptoms before and after treatment, with improvement related to the technique used (VP or LP shunts). Of all patients, 83 were women and 7 were men. In addition, complications were analyzed. Results: Both shunts showed similar postoperative rates of symptom improvement, but VP shunts were utilized more frequently overall in this study. Patients who received LP shunt surgery had a higher rate of postoperative complications compared to those who received VP shunt surgery, but the chi-squared analysis did not provide sufficient evidence to confirm a significant relationship between the type of surgery and the occurrence of postoperative complications. Conclusion: Despite ongoing controversy about the optimal treatment for benign intracranial hypertension (BTC), most authors approved the trend of using VP (ventriculoperitoneal) shunts, given a lower rate of complications. However, there is no statistically significant difference between outcomes of VP and LP (lumboperitoneal) shunting techniques, according to our research.
文摘BACKGROUND Dandy-Walker malformation(DWM)was first reported in 1914.In this case report,a pediatric case was complicated with giant and isolated arachnoid cysts in the right cerebellar hemisphere along with the typical DWM.CASE SUMMARY The patient was at 20 mo old boy,with the complaint of staggering for more than 2 mo.He was admitted to the hospital due to high intracranial pressure and staggering.At admission,the patient had typical manifestations of high intracranial pressure,including vomiting,poor appetite and feeding difficulty.Physical examination revealed increased head circumference,closed anterior fontanelle,unstable standing,staggering,leaning right while walking and ataxia.After admission,he was diagnosed with DWM accompanied by giant isolated arachnoid cysts in the posterior fossa.He underwent Y-shaped three-way valve repair for treating differential pressure between the supratentorial hydrocephalus and the subtentorial arachnoid cysts at once.The child recovered well after the surgery.CONCLUSION In this case,supratentorial and subtentorial shunts were placed,which solved the problem of differential pressure between the supratentorial and subtentorial parts simultaneously.This provides useful information regarding treatment exploration in this rare disease.
基金National Natural Science Foundation of China,No.81773161 and No.81572472.
文摘BACKGROUND The common treatment for hydrocephalus is insertion of a ventriculoperitoneal shunt.Shunt tube displacement is one of the common complications.Most shunt tube displacements occur in children and has a reportedly lower incidence in adults.CASE SUMMARY This study reports an adult patient(male,56 years)who suffered from intracranial aneurysm and subarachnoid hemorrhage and underwent aneurysm clipping following hospitalization.One month post onset of the disease,the patient underwent ventriculoperitoneal shunt due to hydrocephalus.The peritoneal end of the shunt tube was displaced in the peritoneal cavity 9 years after the aneurysm clipping.The peritoneal end of the shunt tube was removed and ventriculoperitoneal shunt was re-performed after anti-inflammatory treatment.CONCLUSION Shunt tube displacement has a low incidence in adults.In order to avoid shunt tube displacement,there is a need to summarize its causative factors and practice personalized medicine.
文摘<b><span style="font-family:Verdana;">Object: </span></b><span style="font-family:""><span style="font-family:Verdana;">Incidence of Idiopathic chronic hydrocephalus of the adult (ICHA) is increasing in Guinea due to the aging of the population. The goal of this study was to describe its epidemiology, clinical presentation, and surgical outcome in a low-resource medical environment. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">Sixteen patients operated for a probable ICHA were prospectively studied according to a uniform protocol</span></span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">from June 2019 to December 2020. On computerized tomography, all operated patients had a clinical triad of gait disturbance, incontinence, dementia associated with ventriculomegaly, and transependymal edema. In addition, all patients underwent a single lumbar tap, improved clinically, and were subsequently offered a shunt consisting of a simple catheter in 37.5% and a non-adjustable high-pressure valve in 62.5%. </span><b><span style="font-family:Verdana;">Result: </span></b><span style="font-family:Verdana;">The mean age was 68.31 </span></span><span style="font-family:Verdana;">±</span><span style="font-family:""> </span><span style="font-family:Verdana;">10.4 (range 49</span><span style="font-family:""> </span><span style="font-family:Verdana;">-</span><span style="font-family:""> </span><span style="font-family:Verdana;">89). The sex ratio H/F was 1.67/1. Clinically, the most frequent comorbidity was a combination of hypertension and diabetes in 56.5% of cases.</span><span style="font-family:""> </span><span style="font-family:Verdana;">The mean time to diagnosis was 8.31 ± 2.75 months (range 3 - 14). The immediate postoperative mortality was 12.5% from a status epilepticus and pulmonary sepsis. In addition, we observed 2 cases of chronic subdural hematoma (12.5%) and 2 cases of shunt dysfunction</span><span style="font-family:""> </span><span style="font-family:Verdana;">(12.5%) in the first three months. The functional outcome was good in 23% of patients at one month (N</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">13), 50% at three months (N = 10), and 87.5% at six months (N = 8). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">In carefully selected cases, the surgical outcome of ICHA in Guinea </span></span><span style="font-family:Verdana;">is</span><span style="font-family:Verdana;"> comparable to high-income countries. Efforts need to be put in helping patients get covered with universal insurance and generally promote Neurosurgery in the country to improve the quality of care.
