119 results match your criteria: "Ventriculoperitoneal Shunt Tap"
Acta Neurochir Suppl
January 2010
Department of Neurosurgery, Unfallkrankenhaus Berlin, Berlin, Germany.
Overdrainage is a common complication observed after shunting patients with idiopathic normal-pressure hydrocephalus (iNPH), with an estimated incidence up to 25%. Gravitational units that counterbalance intracranial pressure changes were developed to overcome this problem. We will set out to investigate whether the combination of a programmable valve and a gravitational unit (proGAV, Aesculap/Miethke, Germany) is capable of reducing the incidence of overdrainage and improving patient-centered outcomes compared to a conventional programmable valve (Medos-Codman, Johnson & Johnson, Germany).
View Article and Find Full Text PDFJ Neurosurg
July 2010
Department of Neurosurgery, Stanford University Medical Center, Stanford, California 94305, USA.
Patients requiring CSF shunts frequently have comorbidities that can influence water and electrolyte balances. The authors report on a case involving a ventriculoperitoneal shunt in a patient who underwent intravenous hyperhydration and withdrawal of vasopressin substitution prior to scheduled high-dose chemotherapy regimen for a metastatic suprasellar germinoma. After acute neurological deterioration, the patient underwent CT scanning that demonstrated ventriculomegaly.
View Article and Find Full Text PDFJ Perinatol
March 2010
Department of Pediatrics, University of Michigan Health System, C.S. Mott Children's Hospital, Ann Arbor, MI 48109-0254, USA.
Objective: Controlled removal of cerebrospinal fluid (CSF) by serial tapping of ventricular reservoir, such as the McComb reservoir, is an effective way to decompress the ventricular system in preterm infants with rapidly progressing post-hemorrhagic ventricular dilatation (PHVD) while awaiting optimal conditions for permanent CSF drainage through a ventriculo-peritoneal shunt. However, the data regarding the risk of infection from repeated invasive tapping of a ventricular reservoir over a prolonged period are scarce. The aim of this study is to determine the incidence of ventricular reservoir infection from repeated tapping and to evaluate how often reservoir infection accompanies blood culture-proven sepsis in preterm infants with PHVD.
View Article and Find Full Text PDFRev Neurol
February 2010
Servicio de Neurocirugía, Hospital General Universitario de Valencia, 46014 Valencia, Espana.
Introduction And Aims: One of the therapeutic options for chronic adult hydrocephalus that has become widely used in our service is the lumboperitoneal shunt with low-pressure Spetzler catheter and in an outpatient regimen. We report on the first 30 patients treated in this way with a follow-up of between one and five years.
Patients And Methods: Diagnosis was reached after studying the patient history and a clinical examination; Hakim and Adams' triad was found to be a primary and highly predictive factor, together with flow magnetic resonance imaging and the use of the ambulatory tap test.
Praxis (Bern 1994)
August 2009
Klinik für Neurochirurgie, Kantonsspital St. Gallen, Rorschacher Strasse 95, St. Gallen.
Normal pressure hydrocephalus (NPH) is characterized by the classic triad of symptoms including gait disturbance, urinary incontinence, and dementia. Gait impairment represents the cardinal symptom. NPH is associated with a radiological verifiable ventriculomegaly in the absence of elevated cerebrospinal fluid (CSF) pressure.
View Article and Find Full Text PDFZhonghua Er Ke Za Zhi
February 2009
Department of Neonatology Yuying Children's Hospital, Wenzhou Medical College, Wenzhou 325027, China.
Objective: Intra-ventricular hemorrhage (IVH) is one of the most serious complications of preterm infants. Significant numbers of the surviving infants with severe IVH go on to develop post-hemorrhagic hydrocephalus (PHH). The management of PHH remains a very challenging problem for both neonatologists and pediatric neurosurgeons.
View Article and Find Full Text PDFChilds Nerv Syst
August 2009
Regional Service of Neurosurgery and Unit of Paediatric Neurosurgery, Virgen de la Arrixaca University Hospital, El Palmar E-30120, Murcia, Spain.
Background: Intra-ventricular haemorrhage (IVH) can occur spontaneously or during the surgical revision of ventricular cerebrospinal fluid (CSF) shunts.
Aim: The aim of the study was to report the safety and efficacy of an original method for treatment of IVH that may occur at the time of valve revision aimed at maintaining the function of previously implanted CSF shunts.
Patients And Methods: We reviewed the medical records of six patients who experienced an IVH in the presence of a previously placed ventriculoperitoneal (VP) shunt.
J Neurosurg Pediatr
June 2008
Department of Neurological Surgery, University of Wisconsin-Madison, Madison, Wisconsin 53792-8660, USA.
Object: The clinical diagnosis of cerebrospinal fluid (CSF) shunt malfunction can be challenging. In this prospective study, the authors evaluated a common method of interrogating shunts: the shunt tap; specifically, its ability to predict proximal malfunction.
Methods: The authors performed standardized shunt taps in a consecutive series of cases involving children with suspected or proven shunt malfunction, assessing flow and, when possible, opening pressure.
J Neurosurg Pediatr
June 2008
Department of Neurological Surgery, University Hospitals of Cleveland, Cleveland, Ohio 44106, USA.
Object: Tapping of a suspected malfunctioning ventriculoperitoneal shunt is usually easy, sometimes informative, but also potentially misleading. The purpose of this study was to determine the effectiveness of a shunt evaluation protocol that does not involve direct shunt tapping except in rare and specific cases.
Methods: The authors adopted a protocol for shunt evaluation that involves shunt tapping only in selected cases of suspected infection or in patients with noncommunicating hydrocephalus and equivocal computed tomography (CT) findings of shunt infection.
Neurosurg Focus
April 2007
Department of Neurology and Neurosurgery, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
Object: The authors attempted to determine whether continuous intracranial pressure monitoring via the shunt reservoir identifies ventriculoperitoneal (VP) shunt malfunctions that are not identified by radionuclide shunt patency study or shunt tap in adults with hydrocephalus.
Methods: During a 2-year period, 26 adults underwent 32 in-hospital continuous intracranial pressure (ICP) monitoring evaluations via needle access of a shunt reservoir. Monitoring was performed for 26.
Childs Nerv Syst
July 2007
Pediatric Neurosurgery, Regina Margherita Children's Hospital, Piazza Polonia 94, Turin, Italy.
Objective: The aim of this study is to retrospectively evaluate a series of consecutive patients affected by post-hemorrhagic hydrocephalus in prematurity, treated with an implant of an Ommaya reservoir followed by ventriculo-peritoneal (VP) shunt and/or endoscopic third ventriculostomy (ETV) to evaluate the safety and efficacy of these treatment options in the management of the condition.
Methods: Between 2002 and 2005, 18 consecutive premature patients affected by intra-ventricular haemorrhage (IVH) grades II to IV, presenting with progressive ventricular dilatation, were operated for implant of an intra-ventricular catheter connected to a sub-cutaneous Ommaya reservoir. Cerebrospinal fluid was intermittently aspirated percutaneously by the reservoir according with the clinical requirements and the echographic follow-up.
J Clin Neurosci
August 2007
Department of Neurosurgery, Haydarpasa Numune Education and Research Hospital, Uskudar, Istanbul, Turkey.
We studied retrospectively the effectiveness of the repeated lumbar CSF tap test (RTT), lumbar external CSF drainage (LED) and radioisotope cisternography (RIC) in predicting the outcome of shunt surgery, as well as the diagnostic and prognostic value of periventricular hyperintensity (PVH) and of the classic clinical triad in normal pressure hydrocephalus. Two hundred and seventy patients were referred to the Departments of Neurosurgery, in Nancy, France and in Istanbul, Turkey. The decision to perform surgery was based on the clinical presentation (all patients had at least two symptoms of the classic clinical triad), neuroimaging examinations and the results of the RTT (taps were performed on three consecutive days and at each tap a minimum of 30 to 40 cc of CSF was removed), the LED (drainage was performed for 3 days and the volume of CSF drained daily was a minimum of 150 to 250 cc) or the RIC.
View Article and Find Full Text PDFNeurol India
December 2006
Department of Neurology and Neurosurgery, Hospital Civil de Guadalajara Fray Antonio Alcalde, Mexico.
Multiple simultaneous intracerebral hemorrhages (ICH) are uncommon. We report the case of an 80-year-old woman with previous diagnosis of normal pressure hydrocephalus and who was brought to our hospital with altered mental status and urinary incontinence. Medical history of hypertension, hematological disorders or severe head trauma was absent.
View Article and Find Full Text PDFPediatr Neurosurg
October 2006
Division of Pediatric Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, Canada.
The authors describe a child with a ventriculo-peritoneal shunt in place for 5 years who presented with 'postural' seizures (seizures on sitting upright, which resolved on recumbency). On shunt tap, the cerebrospinal fluid was obtained freely, but required gentle aspiration with a syringe in the recumbent position, suggesting very low intracranial pressure. Contrast magnetic resonance imaging showed pachymeningeal enhancement and enlargement of the pituitary gland diagnostic of intracranial hypotension along with well-decompressed ventricles.
View Article and Find Full Text PDFJ Neurosurg
March 2006
Department of Neurosurgery, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, New York, USA.
The authors present the case of a 3-year-old girl with a history of myelomeningocele repair, ventriculoperitoneal (VP) shunt placement for hydrocephalus, and shaken baby syndrome who presented in a hypernatremic state as a result of dehydration. At the time of presentation, the patient had experienced a 1-week-long history of diarrhea associated with antibiotic agents used to treat a coexisting pyelonephritis. On admission, the patient exhibited signs and symptoms of dehydration and was discovered to have profound hypernatremia with a serum sodium level of 180 mmol/L.
View Article and Find Full Text PDFNeurosurgery
December 2005
Division of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Objective: Infection after cerebrospinal fluid (CSF) shunts or ventriculostomies is a common complication associated with significant morbidity and mortality. Polymerase chain reaction (PCR) is a powerful molecular technique that allows rapid and precise amplification of bacterial deoxyribonucleic acid (DNA) and has proven a powerful tool in the detection of a wide variety of clinically important infectious diseases. We analyzed specimens of CSF derived from ventriculoperitoneal shunts or external ventricular drains by using both conventional cultures and PCR and report herein our preliminary results.
View Article and Find Full Text PDFNo Shinkei Geka
June 2005
Department of Neurological Surgery, Hiroshima City Hospital, Japan.
Objective And Importance: Ventricular tap is one of the most basic and important techniques to neurosurgeon. Brain tap itself usually does not cause symptomatic complication. The authors report an extremely rare complication case of pneumocephalus caused by failed ventricular tap.
View Article and Find Full Text PDFPurpose: To improve the diagnostic precision of the lumbar tap test (LTT).
Subjects And Methods: Thirty one patients (mean age, 65.4 years; male to female ratio, 12:19) suspected of having idiopathic normal pressure hydrocephalus (INPH) were used in the study.
Eur Neurol
May 2004
Department of Neurosurgery, Unfallkrankenhaus Berlin, Warener Strasse 7, DE-12683 Berlin, Germany.
Despite emerging knowledge of over 40 years, the postoperative results after shunt implantations in patients diagnosed for normal-pressure hydrocephalus (NPH) have not improved significantly in the last decade. For this reason, predictors have to be identified in order to preoperatively predict the course of disease. From 1982 to 2000, we examined in a prospective study 200 patients diagnosed for NPH.
View Article and Find Full Text PDFArch Gynecol Obstet
January 2004
Department of Pediatrics, Indiana University School of Medicine, 702 Barnhill Drive 1740X, Indianapolis, Indiana 46202-5225, USA.
Background: Women with cerebrospinal fluid shunts require special management during the course of pregnancy.
Case Report: We describe a case of delayed postpartum ventriculoperitoneal shunt infection by Group B streptococcus in a 19-year-old who presented complaining of headache and a fever. The CSF culture from the shunt tap and the distal shunt tip both grew Group B beta-hemolytic streptococcus.
Zentralbl Neurochir
April 2003
Klinik für Neurochirurgie, Unfallkrankenhaus Berlin.
In contrast to shunt operation the indication for an endoscopic ventriculostomy in patients diagnosed for normal pressure hydrocephalus is not scientifically established. From September 1997 to October 2001 we operated on 79 patients diagnosed for normal pressure hydrocephalus. Diagnosis was established by means of the intrathecal lumbal or ventricular infusion test, the cerebrospinal fluid tap test and MRI-CSF flow studies pre- and post-operatively.
View Article and Find Full Text PDFBrain Dev
December 2002
Division of Neurosurgery, Kawatetsu Chiba Hospital, Chiba, Japan.
Slit ventricle syndrome, known to occur from malfunction of the shunt procedure for hydrocephalus, is reported after cyst-peritoneal shunt for temporal arachnoid cyst. Two children aged 12 and 10 years, who underwent cyst-peritoneal shunting for a large temporal arachnoid cyst at the age of 10 and 5 years, respectively, recently experienced several episodes of severe headache. Prior to admission, repeated CT scans did not reveal any morphological change in either of these two patients.
View Article and Find Full Text PDFPediatr Emerg Care
August 2002
Department of Pediatrics, University of Connecticut School of Medicine, Connecticut Children's Medical Center, Hartford, Connecticut, USA.
Childs Nerv Syst
July 2002
Department of Neurosurgery, Unfallkrankenhaus Berlin, Warener Strasse 7, 12683 Berlin, Germany.
Objective: In patients with normal-pressure hydrocephalus (NPH) and beginning brain atrophy the conventional differential pressure valve bears the disadvantage of opening abruptly when the patient moves into an upright position. In this way severe suction on the already atrophic brain could be induced. We wished to find whether this disadvantage, and especially the complication of the overdrainage, could be reduced or solved by a hydrostatic valve?
Methods: In 115 patients diagnosed with NPH we implanted 36 Cordis standard valves (CSV), 19 Cordis-Orbis-Sigma valves type I (OSV), and 60 Miethke Dual-Switch valves (M-DSV).