Delayed Catheter-Related Intracranial Hemorrhage After a Ventriculoperitoneal or Ventriculoatrial Shunt in Hydrocephalus

Qian, Zhouqi; Gao, Liang; Wang, Ke; Pandey, Sajan

doi:10.1016/j.wneu.2017.08.098

Cited by 8 publications

(9 citation statements)

References 13 publications

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“…Advanced age, history of craniotomy were considered to be the risk factors for DICH secondary to VP shunt in several articles 8 – 11 , and these factors might increase the fragility of cerebral tissue. However, one article published in 2017 reported that there was no difference between two groups with respect to age 10 . In our study, we also found that history of craniotomy was an independent risk factor for DICH, while advanced age was not.…”

Section: Discussionmentioning

confidence: 99%

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A new inflammatory parameter can predict delayed intracranial hemorrhage following ventriculoperitoneal shunt

Wang

et al. 2021

Sci Rep

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Delayed intracerebral hemorrhage (DICH) secondary to ventriculoperitoneal (VP) shunt is considered to be a potentially severe event. This study aimed to investigate the association between a ratio of postoperative neutrophil-to-lymphocyte ratio to preoperative neutrophil-to-lymphocyte ratio (NLRR) and DICH secondary to VP shunt. We performed a retrospective review of patients who underwent VP shunt between January 2016 and June 2020. Multivariable logistic regression analysis was used to assess the association of DICH and NLRR. Then patients were divided into two groups according to the optimal cut-off point of NLRR, propensity score matching (PSM) method was performed to reconfirm the result. A total of 130 patients were enrolled and DICH occurred in 29 patients. Elevated NLRR and history of craniotomy were independent risk factors for DICH secondary to VP shunt. The optimal cut off point of NLRR was 2.05, and the sensitivity was 89.7%, the specificity was 63.4%. Patients with NLRR > 2.05 had much higher incidence of DICH (40.6% vs 4.5%). Our finding suggested that DICH following VP shunt was not a rare complication and elevated NLRR could independently predict DICH. Inflammatory responses might play an important role in the development of DICH following VP shunt.

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Section: Discussionmentioning

confidence: 99%

“…Patient with small hematoma might be missed if CT scan was not performed frequently 4 . An article published in 2017 reported that the incidence of postoperative DICH was 7.8% (17/218) 10 . In our study, the incidence was 17.5%, which was much higher than previous studies.…”

Section: Discussionmentioning

confidence: 99%

A new inflammatory parameter can predict delayed intracranial hemorrhage following ventriculoperitoneal shunt

Wang

et al. 2021

Sci Rep

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“…Patient with small hematoma might be missed if CT scan was not performed frequently 4 . An article published in 2017 reported that the incidence of postoperative DICH was 7.8% (17/218) 17 . In our study, the incidence was 17.5%, which was much higher than previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…Advanced age, history of craniotomy were considered to be the risk factors for DICH secondary to VP shunt in several articles [15][16][17][18] , and these factors might increase the fragility of cerebral tissue. However, one article published in 2017 reported that there was no difference between two groups with respect to age 17 . In our study, we also found that history of craniotomy was an independent risk factor for DICH, while advanced age was not.…”

Section: Discussionmentioning

confidence: 99%

“…A Korean study found that prolonged partial thromboplastin time was major risk factor of DICH 18 . Some studies showed that dual antiplatelet therapy and postoperative anticoagulation therapy would increase the risk of DICH 17,23 . As for our study, we excluded the patients with anticoagulant or antiplatelet therapy in order to control the confounding factors, and we found that preoperative PT, APTT, INR and PLT were not risk factors for DICH.…”

Section: Discussionmentioning

confidence: 99%

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A New Inflammatory Parameter Can Predict Delayed Intracranial Hemorrhage Following Ventriculoperitoneal Shunt

Wang²,

et al. 2020

Preprint

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Background: Delayed intracerebral hemorrhage (DICH) secondary to ventriculoperitoneal (VP) shunt is considered to be a potentially severe event, however, little is known about the risk factors and underlying mechanisms. This study aimed to investigate the association between NLRR (a ratio of postoperative neutrophil-to-lymphocyte ratio to preoperative neutrophil-to-lymphocyte ratio) and DICH secondary to VP shunt.Methods: We performed a retrospective review of patients who underwent VP shunt between January 2016 and June 2020. Multivariable logistic regression analysis was used to assess the association of DICH and NLRR. Then patients were divided into two groups according to the optimal cut-off point of NLRR, propensity score matching (PSM) method was performed to reconfirm the result.Results: A total of 130 patients were enrolled and DICH occurred in 29 patients. Elevated NLRR (odds ratio [OR], 2.774; 95% confidence interval [CI], 1.372-5.609; P<0.001) and history of craniotomy (OR, 3.505; 95%CI, 1.040-11.813; p=0.043) were independent risk factors for DICH secondary to VP shunt. Receiver operating characteristic curve analysis of NLRR showed that area under the curve was 0.832. The optimal cut off point of NLRR was 2.05, and the sensitivity was 89.7%, the specificity was 63.4%. Patients with NLRR>2.05 had much higher incidence of DICH (OR, 11.25; 95%CI, 1.35-93.50; p=0.025; PSM cohort, n=82). Conclusions: Our finding suggested that DICH following VP shunt was not a rare complication and elevated NLRR could independently predict DICH. Inflammatory responses might play an important role in the development of DICH following VP shunt.

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Thromboembolic infarction caused by an unknown patent foramen ovale 30 years after VA shunt insertion: a case report and review of the literature

et al. 2019

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Delayed Catheter-Related Intracranial Hemorrhage After a Ventriculoperitoneal or Ventriculoatrial Shunt in Hydrocephalus

Cited by 8 publications

References 13 publications

A new inflammatory parameter can predict delayed intracranial hemorrhage following ventriculoperitoneal shunt

A new inflammatory parameter can predict delayed intracranial hemorrhage following ventriculoperitoneal shunt

A New Inflammatory Parameter Can Predict Delayed Intracranial Hemorrhage Following Ventriculoperitoneal Shunt

Thromboembolic infarction caused by an unknown patent foramen ovale 30 years after VA shunt insertion: a case report and review of the literature

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