Intracerebral Hemorrhage Secondary to Ventriculoperitoneal Shunt Insertion  -Four Case Reports-

Misaki, Kouichi; Uchiyama, Naoyuki; Hayashi, Yutaka; Hamada, Jun-ichiro

doi:10.2176/nmc.50.76

Cited by 36 publications

(29 citation statements)

References 9 publications

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“…Shunt surgery carries risks of complications such as cerebral bleeds, subdural hematoma, and infection [10,21,25,29,37]. In addition, some shunted patients develop chronic headaches.…”

Section: Introductionmentioning

confidence: 99%

Predictors of shunt dependency after aneurysmal subarachnoid hemorrhage: results of a single-center clinical trial

Erixon

Sorteberg

et al. 2014

Acta Neurochir

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“…Shunt surgery carries risks of complications such as cerebral bleeds, subdural hematoma, and infection [10,21,25,29,37]. In addition, some shunted patients develop chronic headaches.…”

Section: Introductionmentioning

confidence: 99%

Predictors of shunt dependency after aneurysmal subarachnoid hemorrhage: results of a single-center clinical trial

Erixon

Sorteberg

et al. 2014

Acta Neurochir

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“…1,6 Many studies have noted that intracranial bleeding develops along the path of the ventricular catheter. 5,6,[9][10][11]15,17 Thus, direct surgical injury during ventricular catheter placement is the primary cause of the bleeding after shunt surgery. This catheter-related bleeding might be caused by injuries to the ependymal vessels and choroid plexus after repeated attempts at perforation of the ventricles or the inadequate placement of the catheter within the brain parenchyma.…”

Section: Discussionmentioning

confidence: 99%

Multifocal intraparenchymal hemorrhages after ventriculoperitoneal shunt surgery in infants

Choi¹,

Kim²,

Wang³

et al. 2014

PED

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Object Ventriculoperitoneal (VP) shunt surgery is the most common treatment for hydrocephalus. In certain situations, uncommon complications can occur after shunting procedures. The authors undertook this study to analyze the clinical characteristics of pediatric patients who developed multifocal intraparenchymal hemorrhages (MIPHs) as a complication of shunt surgery. The authors also analyzed the risk factors for MIPH in a large cohort of patients with hydrocephalus. Methods This study included all pediatric patients (age < 18 years) who underwent VP shunt surgery at the authors' institution between January 2001 and December 2012. During this period, 507 VP shunt operations were performed in 330 patients. Four of these patients were subsequently diagnosed as having MIPH. The authors analyzed the clinical characteristics of these patients in comparison with those of the entire group of shunt-treated patients. Results The incidence of MIPH was 1.2% (4 of 330 cases) for all pediatric patients who underwent VP shunt placement but 2.9% (4 of 140 cases) for infants less than 1 year old. When the analysis was limited to patients whose corrected age was less than 3 months, the incidence was 5.3% (4 of 76 cases). Of the 4 patients with MIPH, 2 were male and 2 were female. Their median age at surgery was 54 days (range 25–127 days), and in all 4 cases, the patients' corrected age was less than 1 month. Three patients were preterm infants, whereas one patient was full-term. None of these patients had a prior history of intracranial surgery (including CSF diversion procedures). All showed severe hydrocephalus during the preoperative period. Their clinical courses as patients with MIPH were comparatively favorable, despite the radiological findings. Conclusions MIPH is a rare but not negligible complication of VP shunt surgery. This complication might be a unique phenomenon in infants, especially young, preterm infants with severe hydrocephalus. Moreover, the absence of previous intracranial procedures might be one of the risk factors for this complication. The rapid alteration of brain conditions in the setting of immaturity might cause MIPH. To prevent this complication, the authors recommend that pressure settings of programmable valves should be gradually adapted to the target pressure.

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“…Based on other reported series, the overall incidence of ICH ranges from 0.3% to 4.0%. 20 These injuries can be avoided by minimizing the number of passes through the brain parenchyma, using stereotactic guidance, or placing the catheter via endoscopy. In addition to iatrogenic causes of ICH, complications can also arise from patient comorbidities such as coagulopathy due to liver damage.…”

Section: Complications Of Intraventricular Reservoirs and Shuntsmentioning

confidence: 99%

Surgical Treatment for Leptomeningeal Disease

2017

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Background Advancements in cancer treatment have led to more cases of leptomeningeal disease, which requires a multimodal approach. Methods Treatment modalities are reviewed from a neurosurgical standpoint, focusing on intrathecal chemotherapy and shunting devices. Potential complications and how to avoid them are discussed. Results The Ommaya reservoir and the chemoport are used for administering intrathecal chemotherapy. Use of ventriculo-lumbar perfusion can efficiently deliver chemotherapeutic agents and improve intracerebral pressure. Shunting systems, in conjunction with all of their variations, address the challenge of hydrocephalus in leptomeningeal carcinomatosis. Misplaced catheters, malfunction of the system, and shunt-related infections are known complications of treatment. Conclusions From an oncological perspective, the surgical treatment for leptomeningeal disease is limited; however, neurosurgery can be used to aid in the administration of chemotherapy and address the issue of hydrocephalus. Minimizing surgical complications is important in this sensitive patient population.

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Intracerebral Hemorrhage Secondary to Ventriculoperitoneal Shunt Insertion -Four Case Reports-

Cited by 36 publications

References 9 publications

Predictors of shunt dependency after aneurysmal subarachnoid hemorrhage: results of a single-center clinical trial

Predictors of shunt dependency after aneurysmal subarachnoid hemorrhage: results of a single-center clinical trial

Multifocal intraparenchymal hemorrhages after ventriculoperitoneal shunt surgery in infants

Surgical Treatment for Leptomeningeal Disease

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