Outcome analysis of ventriculoperitoneal shunt procedures in hydrocephalus due to tubercular meningitis and non-infective cases

Tyagi, Devendra K; Balasubramaniam, Srikant; Jayaswal, Shalika; Savant, Hemant V; Gandhi, Anish

doi:10.18203/2349-3291.ijcp20162788

Cited by 8 publications

(5 citation statements)

References 17 publications

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“…The incidence of shunt blockage complications has been reported from 5% to 47%. [ 8 ] In this study, 24.32% patients had proximal catheter blockage and 16.21% patients had distal catheter blockage.…”

Section: Discussionmentioning

confidence: 59%

Outcome analysis of ventriculoperitoneal shunt surgery in pediatric hydrocephalus

Pan¹

2018

J Pediatr Neurosci

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Aim:To study the clinical outcome of shunt surgeries in children with hydrocephalus and evaluate the risk factors for ventriculoperitoneal (VP) shunt failure.Materials and Methods:Patients who underwent VP shunt surgery for hydrocephalus were included. Medical charts, operative reports, imaging studies, and clinical follow-up evaluations were reviewed and analyzed retrospectively.Results:A total of 137 patients with the average age of 20.7 months, range from 1.5 months to 8.5 years at the time of VP shunt surgery were included. The incidence of overall shunt complications was 35.76%; incidence of shunt revision was 27%, shunt blockade 45.94%, shunt infection 16.21%, shunt migration 10.81%, and shunt malfunction due to abdominal pseudocyst 10.81%. The mortality rate was 5.10%. The shunt revisions in the first 6 months after shunt placement was observed in n = 9 (24%). Hydrocephalus was associated with post-tubercular meningitis and intraventricular hemorrhage (IVH) in shunt placement was associated with multiple shunt revisions (n = 13, 35.13%) (n = 5, 45.4%), respectively.Conclusion:The findings of this study indicate that etiology of hydrocephalus, were associated with the shunt survival. Further prospective controlled studies are required to address the observed associations

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Section: Discussionmentioning

confidence: 59%

Outcome analysis of ventriculoperitoneal shunt surgery in pediatric hydrocephalus

Pan¹

2018

J Pediatr Neurosci

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“…The incidence of shunt obstruction has been reported from 5% to 47%. 12 It was 10.94% as reported by Pan P 13 whereas in our study the shunt obstruction was 6.67%.…”

Section: Fig 1 Age At Shunt Placementsupporting

confidence: 50%

Pediatric Ventriculoperitoneal Shunt: Outcome Analysis in a Tertiary Care Center in Nepal

Phuyal

Rajbhandari

Pradhanang

et al. 2020

Journal of Institute of Medicine

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Introduction Ventriculoperitoneal (VP) shunt is a commonly performed neurosurgical procedure in pediatric surgical practice. It results in a dramatic improvement in patient survival and neurological function but is associated with several complications requiring multiple shunt revisions throughout a patient’s lifetime. The main aim of the study was to evaluate the outcome especially complications of shunt surgery at our center. MethodsA single-institutional, retrospective observational study was conducted in 60 operated cases of congenital hydrocephalus with a minimum follow-up for up to 6 months. Parameters for analysis included demographic data, etiology of hydrocephalus, surgery time, and type of complications. ResultsOut of 86 patients, 60 patients who fulfilled the inclusion criteria were enrolled in the study. The mean age of the patients at the time of VP shunt placement was 3 months, range from 8 days to 15 years with male preponderance. The majority of the patients belonged to the 0-1-year age group (76.8%). The commonest etiology of hydrocephalus was congenital aqueduct stenosis. Fifteen patients (25%) developed complications within six months follow-up period. Eight patients (13.3%) developed clinical shunt infection with four cases having culture positive. Four (6.67%) had mechanical complications in the form of shunt obstruction. Three patients had ascites, subdural collection, and shunt extrusion from the anus. The shunt related mortality was 1.67%. ConclusionThe shunt infection and obstruction still remain the most important complications. Despite inherent problems, shunt surgery is the procedure of choice until a safer effective alternative is available.

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“…The inflammatory exudate, partially or completely filling the subarachnoid space and/or the ventricular pathways, can lead to the development of persistent and progressive internal hydrocephalus (i.e., disturbance of the flow, reabsorption or production of the cerebrospinal fluid (CSF) that leads to an increase in volume occupied by the CSF in the CNS) [ 39 , 42 , 60 , 63 , 64 , 81 – 88 ]. Hydrocephalus is one of the most common complications of TBM that occurs in more than two-thirds of the cases [ 64 , 75 , 81 , 82 , 84 – 88 ]. In TBM, either the communicating or the non-communicating type of hydrocephalus can develop, with the former being more common [ 64 , 66 , 75 , 77 , 78 , 82 , 84 , 85 , 87 ].…”

Section: Discussionmentioning

confidence: 99%

Tracking down the White Plague. Chapter three: Revision of endocranial abnormally pronounced digital impressions as paleopathological diagnostic criteria for tuberculous meningitis

et al. 2021

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Abnormally pronounced digital impressions (APDIs) on the endocranial surface develop secondary to a prolonged rise in the intracranial pressure. This can result from a number of pathological conditions, including hydrocephalus due to tuberculous meningitis (TBM). APDIs have been described with relation to TBM not only in the modern medical literature but also in several paleopathological studies. However, APDIs are not pathognomonic for TBM and their diagnostic value for identifying TBM in past human populations has not been evaluated in identified pre-antibiotic era skeletons. To assess the diagnostic value of APDIs for the first time, a macroscopic investigation was performed on skeletons from the Terry Collection (Smithsonian Institution, Washington, DC, USA). Our material consisted of 234 skeletons with tuberculosis (TB) as the cause of death (TB group) and 193 skeletons with non-tuberculous (NTB) causes of death (NTB group). The macroscopic examination focused on the stage of the prominence and frequency of APDIs in the TB group and NTB group. To determine the significance of difference (if any) in the frequency of APDIs between the two groups, χ2 testing of our data was conducted. We found that APDIs were twice as common in the TB group than in the NTB group. The χ2 comparison of the frequencies of APDIs revealed a statistically significant difference between the two groups. In addition, APDIs with more pronounced stages were recorded more frequently in the TB group. Our results indicate that APDIs can be considered as diagnostic criteria for TBM in the paleopathological practice. With suitable circumspection, their utilization provides paleopathologists with a stronger basis for identifying TB and consequently, with a more sensitive means of assessing TB frequency in past human populations.

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Outcome analysis of ventriculoperitoneal shunt procedures in hydrocephalus due to tubercular meningitis and non-infective cases

Cited by 8 publications

References 17 publications

Outcome analysis of ventriculoperitoneal shunt surgery in pediatric hydrocephalus

Outcome analysis of ventriculoperitoneal shunt surgery in pediatric hydrocephalus

Pediatric Ventriculoperitoneal Shunt: Outcome Analysis in a Tertiary Care Center in Nepal

Tracking down the White Plague. Chapter three: Revision of endocranial abnormally pronounced digital impressions as paleopathological diagnostic criteria for tuberculous meningitis

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