Delayed intracerebellar hemorrhage secondary to lumboperitoneal shunt insertion

Er, Uyğur; Akyol, Çetin; Bavbek, Murad

doi:10.4103/1793-5482.145068

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…In addition, the HR for hemorrhagic stroke was lower in the LPS group than in the VPS group, although the difference was nonsignificant. The LPS procedure might be simpler because it is more minimally invasive and does not require ventricular puncture, although it still has the risk of over-drainage [15,29,30]. In addition, mortality was lower in the LPS group than in the VPS group (P < 0.05), which can be attributed to improved iNPH symptoms, safer procedures, fewer adverse effects, and overall lower HRs for MACEs.…”

Section: Discussionmentioning

confidence: 99%

Comparing the Long-Term Cardiovascular Outcomes of Lumbo-Peritoneal, Ventriculo-Peritoneal, or Non-Shunting Treatment after Idiopathic Normal Pressure Hydrocephalus: A Nationwide Retrospective Cohort Study

Chiu,

et al. 2024

Int. J. Med. Sci.

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Purpose: With advances in medical technology, the average lifespan has increased, leading to a growing significance of idiopathic normal pressure hydrocephalus (iNPH), particularly in the elderly population. Most patients with iNPH have been treated either with ventriculo-peritoneal shunts (VPS) or conservative measures. However, lumbo-peritoneal shunts (LPS) have emerged as an alternative treatment option for iNPH in recent decades, extensive research still lacks comparing outcomes with LPS to those with VPS or non-surgical treatment. The aim of the resent study is to disclose the long-term therapeutic outcomes of LPS, VPS, and non-shunting in patients with iNPH. Methods: We used the National Health Insurance Research Database in Taiwan to assess the long-term outcomes of these treatment options. We enrolled 5,537 iNPH patients who received shunting surgery, of which 5,254 were VPS and 283 were LPS. To compare the difference between each group, matching was conducted by propensity score matching using a 1:1 ratio based on LPS patients. Primary outcomes included death and major adverse cardiovascular events (MACEs) Results: Our findings show that VPS resulted in significantly more MACEs than non-surgical treatment (Odds ratio: 1.83, 95% confidence interval: 1.16-2.90). In addition, both VPS and LPS groups had significantly lower overall mortality rates than non-shunting group. Moreover, LPS had lower overall mortality but similar MACEs rates to VPS. Ivyspring International PublisherConclusions: Based on these findings, we propose that the LPS is preferable to the VPS, and surgical treatment should be considered the primary choice over conservative treatment unless contraindications are present.

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Section: Discussionmentioning

confidence: 99%

Comparing the Long-Term Cardiovascular Outcomes of Lumbo-Peritoneal, Ventriculo-Peritoneal, or Non-Shunting Treatment after Idiopathic Normal Pressure Hydrocephalus: A Nationwide Retrospective Cohort Study

Chiu,

et al. 2024

Int. J. Med. Sci.

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“…Ventriculoperitoneal (VP) and lumboperitoneal (LP) shunt operations have no differences in clinical outcomes in the treatment of normal pressure hydrocephalus (NPH). 1 Compared to VP shunt operation, performing LP shunt operation is easier with a shorter operative time; 2 furthermore, it is minimally invasive, which enhances its efficiency in the treatment of NPH. Jia et al reported asuccess rate of 91.40% with LP shunting; only 5.85% of the cases were complicated by shunt tube malfunction, which mainly occurred in the peritoneal tube.…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcome and Safety of Lumboperitoneal Shunt in the Treatment of Non-Obstructive Hydrocephalus

Foo¹,

Tun²,

Chang³

et al. 2023

CIA

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Objective This study aimed to evaluate the functional outcomes of lumboperitoneal (LP) shunt for the treatment of non-obstructive hydrocephalus. Methods We retrospectively studied the clinical surgical results of 172 adult patients with hydrocephalus who underwent LP shunt surgery between June 2014 and June 2019. Data regarding the following were collected: pre- and postoperative symptom status, third ventricle width changes, Evans index, and postoperative complications. Additionally, the baseline and follow-up Glasgow Coma Scale (GCS) score, Glasgow Outcome Scale (GOS), and Modified Rankin Scale (mRS) scores were investigated. All patients were followed up for ≥12 months using clinical interview and braining imaging using computed tomography (CT) scan or magnetic resonance imaging (MRI). Results Majority of patients presented with normal pressure hydrocephalus as the etiology of their disease (48.8%), followed by cardiovascular accident (28.5%), trauma (19.7%), and brain tumor (3%). The mean GCS, GOS, and mRS improved postoperatively. The average period from symptomatic onset to surgery was 402 days. The average width of the third ventricle on CT scan or MRI was 11.43 mm preoperatively and 10.8 mm postoperatively (P<0.001). The Evans index improved from 0.258 to 0.222 after operation. The symptomatic improvement score was 7.0, with a complication rate of 7%. Conclusion Significant improvement was observed in the functional score and brain image after LP shunt placement. Moreover, the satisfaction with symptomatic improvement after surgery remains high. LP shunt operation is a viable alternative in the treatment of non-obstructive hydrocephalus due to the low complication rate, fast recovery, and high satisfaction.

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“…In 2 cases, conservative treatment was applied without any intervention (10,14). One of them died and the GOS score of the other was 5.…”

Section: Treatment Modalitiesmentioning

confidence: 99%

Spontaneous acute subdural hematoma due to intracranial hypotension secondary to lumboperitoneal shunt: a case report and review of the literature

Güzey¹,

Aktaş²,

Tufan³

et al. 2017

Bagcilar Medical Bulletin

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Objective: To report a rare case with spontaneous intracranial acute subdural hematoma due to overdrainage of cerebrospinal fluid after lumboperitoneal shunting and to review the literature on this topic. Case report: A 53-year-old lady with spontaneous acute subdural hematoma developing 3 years after lumboperitoneal shunting for treatment of benign intracranial hypertension is reported. She was treated with shunt removal and hematoma evacuation. Material and Methods: We found 16 cases with intracranial bleeding developing spontaneously or after mild head injury after lumboperitoneal shunting. The characteristics of the patients were recorded, the outcome was given according to the Glasgow Outcome Scale, and a Glasgow Outcome Scale score from 1-3 was accepted as worse outcome. The factors affecting outcome were evaluated. Results: There were 10 females and 7 males aged 59.7±15.1 years. In most cases, the primary disease treated by lumboperitoneal shunting was hydrocephalus or benign intracranial hypertension. In 12 of the cases, the bleeding happened into the subdural space and in 5 into other compartments (intracerebral or subarachnoid bleeding). Five of the cases died, and 62.5% had a worse outcome. The only factor affecting outcome was the time span from lumboperitoneal shunting to intracranial bleeding. This time was significantly shorter in the patients with worse outcome (3.7 versus 38.6 months). Conclusions: Lumboperitoneal shunting may cause serious complications such as intracranial bleeding due to overdrainage of cerebrospinal fluid via shunt. Patients with lumboperitoneal shunting must be followed very closely for development of intracranial hypotension especially during the first few months after shunting. Keywords: acute subdural hematoma, intracranial hemorrhages, intracranial hypotension, lumboperitoneal shunting ÖZETLumboperitoneal şanta bağlı gelişen spontan akut subdural hematom: Olgu sunumu ve literatür taraması Amaç: Lumboperitoneal şant uygulanması sonrası beyin omurilik sıvısının aşırı drenajına bağlı spontan kafaiçi akut subdural hematom gelişen nadir bir olgunun sunulması ve bu konuda literatür taraması yapılması. Olgu Sunumu: Benign kafaiçi hipertansiyon tedavisi için lumboperitoneal şant uygulanmasından 3 yıl sonra spontan akut subdural hematom gelişen 53 yaşında kadın olgu sunuldu. Hasta şantın çıkarılması ve hematomun boşaltılması ile tedavi edildi. Yöntem ve Gereçler: Literatürde lumboperitoneal şant takılması sonrası kendiliğinden ya da hafif kafa travmasıyla kafa içi kanama gelişen 16 olgu bulduk. Hastalıkların özellikleri kaydedildi, sondurum Glasgow sondurum skalasına göre verildi ve Glasgow sondurum skala derecesi 1-3 olması kötü sonuç olarak kabul edildi. Sondurumu etkileyen faktörler değerlendirildi. Bulgular: Toplam 10 kadın ve 7 erkek olgu vardı, yaşları 59.7±15.1 idi. Lumboperitoneal şantla tedavi edilen asıl hastalık olguların çoğunda hidrosefali ya da benign kafaiçi hipertansiyondu. Olguların 12'sinde kanama subdural alana, 5'inde diğer kompartmanlaraydı (intraser...

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Delayed intracerebellar hemorrhage secondary to lumboperitoneal shunt insertion

Cited by 4 publications

References 10 publications

Comparing the Long-Term Cardiovascular Outcomes of Lumbo-Peritoneal, Ventriculo-Peritoneal, or Non-Shunting Treatment after Idiopathic Normal Pressure Hydrocephalus: A Nationwide Retrospective Cohort Study

Comparing the Long-Term Cardiovascular Outcomes of Lumbo-Peritoneal, Ventriculo-Peritoneal, or Non-Shunting Treatment after Idiopathic Normal Pressure Hydrocephalus: A Nationwide Retrospective Cohort Study

Clinical Outcome and Safety of Lumboperitoneal Shunt in the Treatment of Non-Obstructive Hydrocephalus

Spontaneous acute subdural hematoma due to intracranial hypotension secondary to lumboperitoneal shunt: a case report and review of the literature

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