Pleural effusion following ventriculo-pleural shunt: Case reports and review of the literature

Küpeli̇, Eli̇f; Yilmaz, Cem; Akçay, Şule

doi:10.4103/1817-1737.65048

Cited by 54 publications

(28 citation statements)

References 26 publications

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“…Overdrainage of CSF and neurological complications, such as hemorrhage, are low risk, making LP‐HVV a safe procedure . Table shows the different types of shunt procedures and their use …”

Section: Treatmentmentioning

confidence: 99%

Clinical manifestations of hydrocephalus: A review

Schwamb

Dalpiaz

Miao

et al. 2014

Neurology & Clinical Neurosc

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Background: Normal Pressure Hydrocephalus is a disease, which results from excess cerebral spinal fluid, it is often misdiagnosed for other degenerative diseases. Symptoms of Normal Pressure Hydrocephalus may be reversed with new treatment techniques such as shunting. Aims: The aim of this article is to review the pathophysiology of Normal Pressure Hydrocephalus, discuss how to distinguish it from other diseases and discuss treatment options, which show potential for treating Normal Pressure Hydrocephalus. Methods: PubMed was used to conduct searches regarding the subject matter of this article. Results: Gait, dementia and urinary incontinence, which are also referred to as Adam's Triad, are typical associated with Normal Pressure Hydrocephalus. The pathophysiology of these conditions has been outlined in this article. Review articles have been outlined which discuss the potential certain shunt operations have to treat Normal Pressure Hydrocephalus. Discussion: There are several known treatment options that have been successful when treating Normal Pressure Hydrocephalus. With the use of shunts to drain excess cerebral spinal fluid, it is possible to improve the patient's symptoms and thus improve their quality of life. Conclusion: Normal Pressure Hydrocephalus should be considered when treating elderly patients that show signs of Adam's Triad. There are numerous types of treatment options available that show promise as to relieving some of the symptoms that are associated with Normal Pressure Hydrocephalus.

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“…Overdrainage of CSF and neurological complications, such as hemorrhage, are low risk, making LP‐HVV a safe procedure . Table shows the different types of shunt procedures and their use …”

Section: Treatmentmentioning

confidence: 99%

Clinical manifestations of hydrocephalus: A review

Schwamb

Dalpiaz

Miao

et al. 2014

Neurology & Clinical Neurosc

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“…A CSF pseudocyst is a well-recognised complication of CSF diversion catheters that is most commonly associated with ventriculoperitoneal shunts 1. The ventriculopleural shunt is an alternative method of CSF diversion used when ventriculoperitoneal or ventriculoatrial shunts are not suitable due to adhesions, a history of peritonitis, ascites, peritoneal dialysis or failure of a prior ventriculoperitoneal shunt 2.…”

Section: Descriptionmentioning

confidence: 99%

Ventriculopleural shunt CSF pseudocyst presenting as an anterior mediastinal mass

et al. 2013

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“…The procedure should be performed in cooperation with neurosurgery and a cardiac/thoracic surgeon. Even if pleural effusion is a known complication of ventriculo-pleural shunts and usually requires puncture or revision surgery [6,7], the migration of the distal catheter into the pleural cavity, resulting in a ventriculo-pleural shunt, does not always require a mandatory revision. However, patients should be followed closely to recognize possible shunt malfunction.…”

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confidence: 99%

Distal catheter migration of a direct ventriculo-auricular shunt

et al. 2015

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Dear Editor, Surgery for cerebrospinal fluid (CSF) shunts is one of the most frequently performed procedures in neurosurgery [1,3]. However, 20-40 % of complications require revision surgery within the first year [3,9]. The first choice for the placement of the distal catheter is the peritoneal cavity, but distal catheter placement to the venous system can be achieved by cannulating, e.g., the internal jugular vein as well. Nevertheless, infection, thrombosis, or glomerulonephritis can necessitate alternate sites of distal catheter placement. If traditional placement sites of the distal catheter are not suitable, direct placement into the right auricle could be considered.A 34-year-old male patient with a history of internal hydrocephalus had received a ventriculo-atrial shunt (VA-shunt) 3 months after birth. He underwent four revisions with both VA-and ventriculo-peritoneal shunts (VP-shunt). His past medical history was remarkable for multiple abdominal surgeries including two kidney transplantations. The patient presented with evidence of peritonitis and hydrocephalus and cranial computed tomography (cCT) showed increased ventricle size. Abdominal ultrasound revealed massive ascites, therefore the distal catheter of the VP shunt was removed, the shunt was externalized, and the patient received antibiotics until recovery from peritonitis. A CT angiogram revealed extensive venous thrombosis and the peritoneal cavity was no longer an option due to previous failure. Concerning the need of 300 ml of CSF drainage per day and the high risk of pleural effusion due to renal insufficiency, pleural catheter placement seemed to be unsuitable as well. Therefore the direct placement of the distal catheter into the right atrium in cooperation with a cardiac surgeon appeared to be the most feasible option.The ventricular catheter was replaced and connected with a burr hole reservoir, an adjustable valve, and adjustable shunt assistant. The thoracotomy was performed and the right lung was deflated, allowing smooth retraction of the lung and exposure of the pericardium. A sub-cutaneous tunnel was constructed from the thoracotomy to a subclavian skin incision where the atrial catheter was inserted. The pericardium was incised and after placement of a felt-reinforced purse string suture, the auricle was opened and the cardiac catheter was placed into the right atrium. After verifying the placement, an additional anchorage to the pericardium was applied by using a plastic catheter fixation (Fig. 1). The amply chosen atrial catheter was fed through the subcutaneous tunnel and connected to the proximal catheter.Postoperative radiograph and cCT showed proper catheter placement and decreased ventricle size. Two months after discharge, the patient presented with right thoracic pain. A chest CT revealed pleural effusion and migration of the atrial catheter to the pleural cavity. Since there were no clinical or radiographic signs of hydrocephalus, the clinical team decided to observe the patient and to avoid a revision surgery. Subsequen...

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Pleural effusion following ventriculo-pleural shunt: Case reports and review of the literature

Cited by 54 publications

References 26 publications

Clinical manifestations of hydrocephalus: A review

Clinical manifestations of hydrocephalus: A review

Ventriculopleural shunt CSF pseudocyst presenting as an anterior mediastinal mass

Distal catheter migration of a direct ventriculo-auricular shunt

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