Hydrocephalus: Overdrainage by ventricular shunts. A review and recommendations

Pudenz, Robert H.; Foltz, Eldon L.

doi:10.1016/0090-3019(91)90072-h

Cited by 257 publications

(132 citation statements)

References 35 publications

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“…Manifestations include slit ventricle syndrome, intracranial hypotension syndrome (IHS), subdural fluid collections, and other rarer conditions. 10,12 The characteristic triad of IHS consists of postural headache, diffuse pachymeningeal enhancement on MR images obtained after gadolinium administration, and low CSF opening pressure. 1,9 Although orthostatic headache is the most characteristic symptom, patients may have chronic or intermittent headache or even no headache.…”

Section: Discussionmentioning

confidence: 99%

Overshunting-associated myelopathy: report of 2 cases

Law

Yuen

et al. 2016

FOC

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The authors present 2 cases of cervical myelopathy produced by engorged vertebral veins due to overshunting. Overshunting-associated myelopathy is a rare complication of CSF shunting. Coexisting cervical degenerative disc disease may further increase the difficulty of diagnosing the condition. Neurosurgeons and others who routinely evaluate patients with intracranial shunts should be familiar with this rare but possible diagnosis.

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Section: Discussionmentioning

confidence: 99%

Overshunting-associated myelopathy: report of 2 cases

Law

Yuen

et al. 2016

FOC

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“…biceps contraction No formal assessment of the effect of the vertical infraclavicular block on lung volumes has been made. However, there exists a report of the absence of changes in lung function tests associated with the use of a modification [11] of Sims's modification [12] of Raj et al's infraclavicular brachial plexus block [13]. It is interesting to note that the induction of the brachial plexus block in our case was associated with a change in FVC from 1.7 to 1.2 l, a 29% decrease, the order of magnitude of which is in keeping with the known effects of phrenic nerve paralysis caused by brachial plexus blocks [4].…”

Section: Discussionmentioning

confidence: 99%

The use of a vertical infraclavicular brachial plexus block in a patient with myasthenia gravis: effects on lung function

2001

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SummaryA patient who was suffering an exacerbation of myasthenia gravis dislocated her elbow. She underwent closed reduction of the dislocation under vertical infraclavicular brachial plexus blockade. The technique was successful but was associated with a 29% decrease in forced vital capacity, from 1.7 l to 1.2 l. The patient did not show any symptoms of ventilatory failure. Her recovery was uncomplicated.

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“…4,21 Efforts have been made to determine intracranial pressure as a relevant pathophysiological and diagnostic factor for hydrocephalus. 2,5,10,19,23 In contrast, determination of intraperitoneal pressure (IPP) as part of the preoperative assessment remains neglected and is still debated in the literature. Reported values range from subatmospheric to 15-25 cm H 2 O regardless of the intraperitoneal location, reference level, body position, and measurement technique.…”

confidence: 99%

Differential pressure in shunt therapy: investigation of position-dependent intraperitoneal pressure in a porcine model

Freimann¹,

Ötvös²,

Chopra

et al. 2013

PED

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Object The differential pressure between the intracranial and intraperitoneal cavities is essential for ventriculoperitoneal shunting. A determination of the pressure in both cavities is decisive for selecting the appropriate valve type and opening pressure. The intraperitoneal pressure (IPP)—in contrast to the intracranial pressure—still remains controversial with regard to its normal level and position dependency. Methods The authors used 6 female pigs for the experiments. Two transdermal telemetric pressure sensors (cranial and caudal) were implanted intraperitoneally with a craniocaudal distance of 30 cm. Direct IPP measurements were supplemented with noninvasive IPP measurements (intragastral and intravesical). The IPP was measured with the pigs in the supine (0°), 30°, 60°, and vertical (90°) body positions. After the pigs were euthanized, CT was used to determine the intraperitoneal probe position. Results With pigs in the supine position, the mean (± SD) IPP was 10.0 ± 3.5 cm H2O in a mean vertical distance of 4.5 ± 2.8 cm to the highest level of the peritoneum. The difference between the mean IPP of the cranially and the caudally implanted probes (Δ IPP) increased according to position, from 5.5 cm H2O in the 0° position to 11.5 cm H2O in the 30° position, 18.3 cm H2O in the 60° position, and 25.6 cm H2O in the vertical body position. The vertical distance between the probe tips (cranially implanted over caudally implanted) increased 3.4, 11.2, 19.3, and 22.3 cm for each of the 4 body positions, respectively. The mean difference between the Δ IPP and the vertical distance between both probe tips over all body positions was 1.7 cm H2O. Conclusions The IPP is subject to the position-dependent hydrostatic force. Normal IPP is able to reduce the differential pressure in patients with ventriculoperitoneal shunts.

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Hydrocephalus: Overdrainage by ventricular shunts. A review and recommendations

Cited by 257 publications

References 35 publications

Overshunting-associated myelopathy: report of 2 cases

Overshunting-associated myelopathy: report of 2 cases

The use of a vertical infraclavicular brachial plexus block in a patient with myasthenia gravis: effects on lung function

Differential pressure in shunt therapy: investigation of position-dependent intraperitoneal pressure in a porcine model

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