Shunt overdrainage syndrome: review of the literature

Ros, Bienvenido; Iglesias, Sara; Martín-Gallego, Álvaro; Carrasco, Alonso; Ibáñez, Guillermo; Arráez, Miguel Ángel Escribano

doi:10.1007/s10143-017-0849-5

Cited by 53 publications

(53 citation statements)

References 118 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…With time, the frequent revision rates and complications have provoked multiple changes and advancements in both VP shunt equipment, including the catheters and valve mechanisms [9,13], as well as the surgical procedure itself [9]. Traditionally, VP shunts have been inserted using mini-laparotomy, although recently, a neuronavigated laparoscopically assisted approach has become a more commonly accepted surgical technique [9,14].…”

Section: Ventriculoperitoneal Shunt: Challengesmentioning

confidence: 99%

Neuronavigated and Laparoscopic-Assisted Ventriculoperitoneal Shunt Placement

Wilson¹,

Crozier²,

Helou³

2020

New Insight Into Cerebrovascular Diseases - An Updated Comprehensive Review

View full text Add to dashboard Cite

Hydrocephalus is an abnormal accumulation of excess cerebrospinal fluid (CSF) in the brain causing increased intracranial pressure, which can arise from a variety of causes, including congenital, acquired, or idiopathic pathologies. Ventriculoperitoneal (VP) shunting is most commonly used to treat hydrocephalic patients, relieving the increased intracranial pressure by draining excess CSF from the ventricles to the peritoneal cavity. VP shunts are primarily completed using either an open or a more minimally invasive neuronavigated laparoscopic-assisted surgical technique. There is a high level of surgical complications, shunt failures and revision rates following VP shunting. It is suggested that different surgical techniques are associated with varying degrees of patient outcomes, surgical complications, and revision rates, with the less invasive laparoscopic-assisted approach producing improved results. We present our results on 14 consecutive hydrocephalic patients, analyzed retrospectively between 2017 and 2019, investigating the benefits offered by the neuronavigated laparoscopic-assisted insertion of VP shunts. Additionally, we explain our workflow and procedural technique. By investigating these differences, changes can be implemented in current routine procedures to ameliorate patient safety, surgical complications, and revision rates.

show abstract

Section: Ventriculoperitoneal Shunt: Challengesmentioning

confidence: 99%

Neuronavigated and Laparoscopic-Assisted Ventriculoperitoneal Shunt Placement

Wilson¹,

Crozier²,

Helou³

2020

New Insight Into Cerebrovascular Diseases - An Updated Comprehensive Review

View full text Add to dashboard Cite

show abstract

“…32 Given our endoscopic findings, it is intriguing to consider the consequences of CSF overshunting on the immature brain and ventricles and in light of a flexible skull susceptible to craniocerebral disproportion. 34 Such biophysical properties may place younger patients at higher risk of ventricular catheter obstruction.…”

Section: Ventricular Size Ventricular Tip Environment and Proximal Shunt Obstructionmentioning

confidence: 99%

Overdrainage-related ependymal bands: a postulated cause of proximal shunt obstruction

Kraemer¹,

Koueik²,

Rebsamen

et al. 2018

Journal of Neurosurgery: Pediatrics

View full text Add to dashboard Cite

OBJECTIVEVentricular shunts have an unacceptably high failure rate, which approaches 50% of patients at 2 years. Most shunt failures are related to ventricular catheter obstruction. The literature suggests that obstructions are caused by in-growth of choroid plexus and/or reactive cellular aggregation. The authors report endoscopic evidence of overdrainage-related ventricular tissue protrusions (“ependymal bands”) that cause partial or complete obstruction of the ventricular catheter.METHODSA retrospective review was completed on patients undergoing shunt revision surgery between 2008 and 2015, identifying all cases in which the senior author reported endoscopic evidence of ependymal tissue in-growth into ventricular catheters. Detailed clinical, radiological, and surgical findings are described.RESULTSFifty patients underwent 83 endoscopic shunt revision procedures that revealed in-growth of ventricular wall tissue into the catheter tip orifices (ependymal bands), producing partial, complete, or intermittent shunt obstructions. Endoscopic ventricular explorations revealed ependymal bands at various stages of development, which appear to form secondarily to siphoning. Ependymal bands are associated with small ventricles when the shunt is functional, but may dilate at the time of obstruction.CONCLUSIONSVentricular wall protrusions are a significant cause of proximal shunt obstruction, and they appear to be caused by siphoning of surrounding tissue into the ventricular catheter orifices.

show abstract

“…Гипердренирование ликвора является одним из наиболее частых осложнений шунтирующих операций и его частота достигает 20-30% [10,61,62]. Синдром гипердренирования может быть связан с ошибочным выбором давления открытия клапана шунта и/или сифонным эффектом при вертикализации пациента [10,28,63,64].…”

Section: дисфункции шунтирующих систем синдромы неадекватного дренирunclassified

“…Клиническая картина при синдроме гипердренирования ЦСЖ вариабельна, но обычно проявляется нарастанием очаговой и общемозговой симптоматики. На фоне гипердренирования может происходить изоляция желудочков мозга, «спадение» стенок желудочков (slit-ventricle syndrome), нередко развиваются субдуральные гематомы и гигромы [10,62].…”

Section: дисфункции шунтирующих систем синдромы неадекватного дренирunclassified

“…Синдромы недостаточного дренирования развиваются в результате механических причин, таких как обтурация вентрикулярного катетера (например, сосудистым сплетением), обрыв или миграция концов катетеров (как вентрикулярного, так и перитонеального), дисконнекция компонентов шунтирующей системы, развитие абдоминальных псевдокист, недостаточное дренирование клапаном шунтирующей системы [10,62]. Проявлениями недостаточного дренирования ликвора являются отрицательная динамика неврологического статуса пациентов с возвратом ее на дооперационный уровень.…”

Section: дисфункции шунтирующих систем синдромы неадекватного дренирunclassified

See 1 more Smart Citation

Modern diagnostics and treatment of posttraumatic hydrocephalus

et al. 2018

View full text Add to dashboard Cite

One of the frequent consequences of severe traumatic brain injury is posttraumatic hydrocephalus that not only hampers the processes of consciousness recovery, rehabilitation, and social adaptation of patients but also is the cause of disability. Pathological processes underlying the clinical picture of posttraumatic hydrocephalus and the relationship between CSF circulation disorders and structural changes in the brain substance have not been adequately studied. Of particular importance are patients in the chronic vegetative or minimally conscious state, recovery from which is blocked by posttraumatic hydrocephalus. The question of reversibility of impaired consciousness depending on the disease duration has remained open. High risks of purulent-inflammatory complications of shunting surgery are especially important in patients with chronic infection foci (tracheostomy, gastrostomy, epicystostomy, prolonged bladder catheterization, pressure ulcers, etc.), but their actual effect on the shunting outcomes has not been revealed. Posttraumatic hydrocephalus remains a topical neurosurgical problem requiring clarification of its diagnostic criteria, differentiation from atrophy-related ventriculomegaly, and comprehensive development of pathogenetic and therapeutic aspects.

show abstract

Shunt overdrainage syndrome: review of the literature

Cited by 53 publications

References 118 publications

Neuronavigated and Laparoscopic-Assisted Ventriculoperitoneal Shunt Placement

Neuronavigated and Laparoscopic-Assisted Ventriculoperitoneal Shunt Placement

Overdrainage-related ependymal bands: a postulated cause of proximal shunt obstruction

Modern diagnostics and treatment of posttraumatic hydrocephalus

Contact Info

Product

Resources

About