Interaction of ventriculoperitoneal shunt and baclofen pump.

Childs Nerv Syst

Pediatric Neurosurgery Service, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, 702 Barnhill Drive, Room 1134, Indianapolis, IN 46202, USA.

Published: July 2007

Objective: The authors present three cases of children with shunted hydrocephalus and intrathecal delivery of baclofen via an implanted pump. Each case illustrates a potential interaction of these devices.

Materials And Methods: A review of the pertinent charts, operative notes, and discharge summaries was performed, along with examination of the pertinent literature.

Conclusion: The first case illustrates that a change in the pharmacology or effect of intrathecal baclofen may be caused by a failure of a shunt affecting cerebrospinal fluid clearance. The second case illustrates that patients can have ventricular changes with any procedure that accesses the thecal space, even with a functioning shunt. The third case illustrates that ensuring that a patient's shunt is functional before implantation of a baclofen pump is imperative. As the potential pool of patients with both shunted hydrocephalus and need for intrathecal baclofen grows, clinicians should be aware of potential serious interactions.

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http://dx.doi.org/10.1007/s00381-007-0298-5DOI Listing

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