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Spinal Anesthesia in Infant with Ventriculoperitoneal Shunt: A Case Report of Inguinal Hernia Repair  [PDF]
Gian Matteo Pedrazzi, Gianfranco Montanari, Vincenzo Domenichelli
Open Journal of Anesthesiology (OJAnes) , 2016, DOI: 10.4236/ojanes.2016.66016
Abstract: 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.
Hydrocephalies and Vestibular Schwannoma of Great Size: Therapeutic Strategies: About a Series of 32 Cases  [PDF]
Moussa Diallo, Romuald Kouitcheu, Lucas Troude, Anthony Melot, Jean-Marc Kaya, Adamou Touta, Samuel Malca, Pièrre-Hugues Roche
Case Reports in Clinical Medicine (CRCM) , 2018, DOI: 10.4236/crcm.2018.75034
Abstract: Introduction: The association hydrocephalus and vestibular schwannoma (VS) has been known for a long time. However, there is no therapeutic consensus, especially the place of drainage of cerebrospinal fluid (CSF). We report the result of our experience on the management of this pathology from a group of patients with a high volume VS (Koos IV) and operated consecutively. After reflections based on current literature data, we propose a therapeutic decisional algorithm. Materials and Methods: This is an analytical, retrospective study of 171 patients operated on KOOS IV vestibular schwannoma from January 2003 to December 2016 at the Marseille University Hospital Center. Of these, 32 patients with hydrocephalus and stage IV vestibular schwannoma were included. Radio-diagnostic criteria for hydrocephalus were based on Evans’ index, cortical furrow status, and the presence of trans-ependymal resorption. Our sample was divided into 2 groups. The first consisted of patients first operated on their hydrocephalus and secondarily treated with schwannoma surgery (group I); patients who underwent surgical resection of their first-line tumor were group II. Epidemiological, clinical, radiological, therapeutic and monitoring data were analyzed. The comparison of the quantitative variables was made by Fisher’s test. Results: During our study period (13 years), 171 cases of stage IV SV had been operated. The association between hydrocephalus and SV stage IV of Koos accounted for 18.7%. The average age of our patients was 53 years with a sex ratio of 0.7. The clinical picture was primarily composed of otological signs (90.6%), headache (56.3%) and cerebellar involvement (43.8%). The average diameter of VS inponto-cerebellar angle (PCA) was 31.5 mm. The treatment consisted of placing a first shunt of the CSF in 34.4% (group I). The ventriculoperitoneal shunt (VPS) was performed in 90.9% of cases. The first surgical removal of the tumor (group II) involved 65.6% of the patients. The postoperative tumor residue averaged 0.76 cc. The Evans index was evaluated on average at 0.33 in each of the 2 groups postoperatively. The average follow-up time for patients was 51 months. Eight cases of complications were recorded during the study. Secondly, in group II, VPS was performed in 9.5% (2 cases). Conclusion: Hydrocephalus is a condition commonly associated with stage IV vestibular schwannoma. The first optimal surgical excision of the tumor seems to be the treatment of choice for this pathological association. The success of the surgery is very
Gigantic Abdominal Pseudocyst: An Unusual Evolution of the Ventriculoperitoneal Shunt  [PDF]
Alícia de Oliveira Mendes, Fernanda Aquino Freres Silva, Willy Marcus Fran？a
Open Journal of Modern Neurosurgery (OJMN) , 2021, DOI: 10.4236/ojmn.2021.114029
Abstract: Background: 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. Aim: To report an unusual case of a giant abdominal cerebrospinal fluid pseudocyst as a complication of the VPS. Case Presentation: Female 1 y/3 months 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), São Paulo. Conclusion: Abdominal CSF as a cause of these giant pseudocysts should be considered as a diagnostic hypothesis for cases of large abdominal distensions without intestinal involvement in
Outcome of Children under Five Years Old Operated on for Hydrocephalus in University Hospital Centers in Togo  [PDF]
Abd El Kader Moumouni, Maman Sani Rabiou, Essosalam Essotina, Dabou Abiba Tamou Tabe, Doleagbenou Komlan Agbeko, Solim Mariam Tablousma, Opekou Donkor Fabie, Hodabalo Essosolim Bakonde, Winie Tchedre, Oniwa Solange Katagna, Ramdane Issifou, Katanga Anthony Beketi, Essosinam Kpélao
Open Journal of Modern Neurosurgery (OJMN) , 2026, DOI: 10.4236/ojmn.2026.162019
Abstract: Introduction: Infant hydrocephalus remains a major public health problem in sub-Saharan Africa, where the prognosis is still marked by high mortality and significant sequelae, despite advances in neurosurgery. In Togo, data on the medium- and long-term outcomes of operated children are still scarce. The objective of this study was to assess the vital, neurodevelopmental, and social outcomes of children under five years old who underwent surgery for hydrocephalus in Togo. Study Setting and Methodology: This was a descriptive and analytical, retrospective study with prospective data collection, conducted from January 1, 2011, to December 31, 2021, in the university hospital centers (CHU) of Togo. All children aged ≤ 5 years who underwent surgery for hydrocephalus exclusively by ventriculoperitoneal shunt (VPS) were included. Sociodemographic, clinical, diagnostic, therapeutic, and outcome data were analyzed. Results: Seventy-one children were included. The mean age was 8 ± 0.95 months, with a male predominance (56.34%). Congenital malformations were the main etiology (47.89%). All patients had undergone ventriculoperitoneal shunting (VPS). Immediate postoperative mortality was zero (0%), but with a follow-up of 5 to 15 years, it reached 43.66%. Among the survivors, 52.11% showed improvement in psychomotor development, 32.39% had stable development, and 15.49% experienced regression. Surgery performed at ≤ 5 months of age was significantly associated with better survival (OR = 3.10; p = 0.022) and fewer sequelae. A management delay of ≤ 14 days was significantly associated with better survival (OR = 3.29; p = 0.0375). Conclusion: Operated infantile hydrocephalus in Togo remains associated with high mortality and major sequelae, mainly due to delayed diagnosis and insufficient postoperative follow-up. Enhanced early screening, multidisciplinary follow-up, and better access to specialized care would improve the prognosis.
Cerebrospinal Fluid Diversion Procedures for Treatment of Idiopathic Intracranial Hypertension: Single Center Experience  [PDF]
Mahmoud M. Taha, Safwat Abouhashem, Ayman Abedelrahman
Open Journal of Modern Neurosurgery (OJMN) , 2017, DOI: 10.4236/ojmn.2017.73009
Abstract: Idiopathic intracranial hypertension (IIH) is a disorder characterized by increased intracranial pressure without any identifiable etiology with normal brain imaging and normal cerebrospinal fluid (CSF) content. CSF diversion procedures are commonly used for treatment if medical treatment failed. The aim of this study is to report our experience in treatment of IIH with lumboperitoneal (LP) and stereotactic guided ventriculoperitoneal (VP) shunts. The clinical data of 43 consecutive patients with IIH refractory to medical treatment and underwent CSF diversion procedures between 2009 and 2014 were analyzed. 29 patients underwent LP shunts and the remaining 14 patients underwent stereotactic guided Ventricular shunts. All patients underwent clinical, imaging and CSF manometry evaluation. 38 (88.4%) patients were female and the remaining 5 (11.6%) patients were male. The mean age was 27.2 years. The opening pressure was above 300 mm H2O in 26 (69.8%) patients. Headache (100%) and blurring and/or diminution of vision (81.4%) were the commonest clinical presentation. 36 (83.7%) patients reported recovery of their headache and 30 (69.7%) patients showed complete resolution of papilledema. The clinical outcome between both procedures was not significant. The incidence of perioperative complications (20.7% vs. 0%) and shunt revisions (27.6% vs. 7.1%) were higher in patients with LP shunt than patients with stereotactic Ventricular shunts. The results of this study demonstrate that both LP and Ventricular shunts are valid diversion procedures for treatment of IIH. Stereotactic guided Ventricular shunt has lower incidence of complications and revisions and seems to be safe, effective and feasible alternative procedure for treatment of IIH.
Infec？？es em dispositivos neurológicos implantáveis em crian？as e adolescentes
Lima, Márcia Maria Macêdo;Pereira, Carlos Umberto;Silva, Angela Maria;
Arquivos de Neuro-Psiquiatria , 2007, DOI: 10.1590/S0004-282X2007000100024
Abstract: objective: to determine frequency, etiology, site and clinical and laboratory findings of ventriculoperitoneal shunt (vps) infections in children and adolescents with hydrocephalus managed in hospital governador jo？o alves filho, aracaju se, brazil. method: a non-controlled prospective observational study comprising 50 patients that underwent vps (58 procedures) from january/2003 to october/2004. results: infection rate per procedure was 27.6%; surgical risk index (nniss-cdc) 0 and 1-2 were 25.7% and 30.4% respectively; surgical site infection was the main complication with 50% of the cases. conclusion: infection rates per procedure, per patient, and per surgical risk index were high. no statistical differences were found related to the following: age, etiology of hydrocephalus, type of procedure, pre-operative length of stay, duration of procedure, antibiotic prophylaxis, previous central nervous system catheter, and surgical risk index.
Tratamento de hidrocefalia com deriva？？o ventrículo-peritoneal: análise de 150 casos consecutivos no Hospital das Clínicas de Ribeir？o Preto
Jucá, Carlos Eduardo Barros;Lins Neto, Ant？nio;Oliveira, Ricardo Santos de;Machado, Hélio Rubens;
Acta Cirurgica Brasileira , 2002, DOI: 10.1590/S0102-86502002000900013
Abstract: introduction/objectives: this study has analyzed 150 consecutive cases of treatment of hydrocephalus by ventriculoperitoneal shunt in the faculty of medicine of ribeir？o preto's hospital between may 1997 and july 2000, in order to stablish the main characteristics of the patients and proceedings , in particular the etiologies, diagnosis, complications, final outcome and associated factors. methods: medica records as a source for assesment of the selected variables. results: the congenital and the acquired etiologies had the same incidence, with the complexes malformations and the complications of prematurity and meningitis with distinction in each group respectively. the main complications were malfunction of the valve (33%) and infection (15%). including the operations caused by complications, there were 2,5 surgical proceedings to each patient, on average. in the final examination, 40% of the patients had some level of neurological deficit. the main etiologies related to this deficits were prematurity , meningitis and the complexes malformations. discussion: this report has contributed to characterize the evolution and treatment of hydrocephalus in our environment, producing basis to make comparisons with the literature and with other services. the rate of neurological deficit agrees with the literature. the rate of infection is higher, maybe because it is a universitary hospital. a longer period of observation would be necessary to compare the incidences of mechanical complications.
Derivación ventrículo-peritoneal y embarazo. Reporte de tres casos y revisión de la literatura
Benítez,Gidder; Tejada,Paúl; Moros,José; Rumbao,Fabio; Silva,María Da; Medina,Nora;
Revista de Obstetricia y Ginecología de Venezuela , 2001,
Abstract: summary: three cases of pregnancy in patients with ventriculoperitoneal shunts for hydrocephalus are presented. we present a review of the current literature regarding obstetric and anesthesic management
Asymptomatic perforation of large bowel and urinary bladder as a complication of ventriculoperitoneal shunt: Report of two cases
Mihajlovi？ Miljan,Tasi？ Goran,Rai？evi？ Mirjana,Mrdak Milan
Srpski Arhiv za Celokupno Lekarstvo , 2012, DOI: 10.2298/sarh1204211m
Abstract: Introduction. Insertion of a ventriculoperitoneal (VP) shunt, the method of choice in the treatment of hydrocephalus, is often followed by various mechanical and/or infective complications. We present two children with asymptomatic perforation of the large bowel and urinary bladder, relatively rare and potentially severe complications of this surgical procedure. Outline of Cases. In both patients a VP shunt was implanted in the first month after birth; in a boy due to congenital hydrocephalus and in a girl due to the consequences of intracranial haemorrhage. Immediately after surgery, as well as during the further course, in both children growth and development were optimal and without any signs of infection or VP shunt malfunction. In the boy at age 6 months and in the girl at age 4 years, without any signs of complications, mothers noted the prominence of the VP shunt tip from the anus in the first case and from the urethral orifice in the second one. The VP shunts were immediately changed, so that both complications were resolved without any consequences. Conclusion. Insertion of a VP shunt represents the most frequent method of choice of the surgical treat- ment of hydrocephalus, but also potentially a highly risky procedure followed by various complications about which parents should be informed when patients are children. Owing to adequate approach in the follow-up of children with implanted VP shunt, large bowel and urinary bladder perforation, examples of severe and potentially fatal complications of this surgical intervention, could be disclosed on time and adequately resolved.
An experience with ventriculoperitoneal shunting at keen’s point for hydrocephalus
Mamoon Ahmed,Mamoon Ur Rashid,Muhammad Junaid
- , 2018, DOI: 10.12669/pjms.343.14081
Abstract: This study was conducted to assess outcomes in patients with hydrocephalus who underwent ventriculoperitoneal shunting at Keen’s point
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