The role of surgery in relieving calcified shunt site-related pain in patients with functioning VP shunt

Baig, Rehman Ali; Davis, James; Rodrigues, Desiderio; Lo, William B.; Kaliaperumal, Chandrasekaran; Gallo, Pasquale

doi:10.1007/s00381-022-05733-y

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…Specifically, this pain can occur at the shunt valve site or more distally along the shunt distal tubing. Interestingly, shuntodynia has been reported with and without shunt malfunctions 8 , 9 . Though clinically recognized, the condition has not received significant attention since it is usually seldom life-threatening.…”

Section: Introductionmentioning

confidence: 99%

“…Interestingly, shuntodynia has been reported with and without shunt malfunctions. 8 , 9 Though clinically recognized, the condition has not received significant attention since it is usually seldom life-threatening. The presence of shuntodynia is indicative of patient discomfort, and there is significant physical and psychosocial burden associated with implanted shunt devices.…”

Section: Introductionmentioning

confidence: 99%

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Can diffuse reflectance spectroscopy identify shuntodynia in pediatric hydrocephalus patients?

Kline,

Vishwanath,

Colbrunn

et al. 2024

J. Biomed. Opt.

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Shuntodynia is patient reported pain at the site of the implanted ventriculoperitoneal (VP) shunt. Pediatric hydrocephalus requiring shunt placement is a chronic and prevalent standard of care treatment and requires lifetime management. Shuntodynia is a subjective measure of shunt dysfunction. Quantitative, white-light tissue spectroscopy could be used to objectively identify this condition in the clinic.Aim: Pediatric subjects were recruited for optical sensing during routine clinical follow-up visits, post-VP shunt implantations. Acquired optical signals were translated into skin-hemodynamic signatures and were compared between subjects that reported shuntodynia versus those that did not.Approach: Diffuse reflectance spectroscopy (DRS) measurements were collected between 450 and 700 nm using a single-channel fiber-optical probe from (N ¼ 35) patients. Multiple reflectance spectra were obtained by the attending physician from regions both proximal and distal to the VP shunt sites and from a matched contralateral site for each subject. Acquired reflectance spectra were processed quantitatively into functional tissue optical endpoints. A two-way, repeated measures analysis of variance was used to assess whether and which of the optical variables were statistically separable, across subjects with shuntodynia versus those without.Results: Analyses indicated that intrapatient differences in vascular oxygen saturation measured between shunt sites relative to that obtained at the scar or contralateral sites was significantly lower in the pain group. We also find that the total hemoglobin concentrations at the shunt site were lowest relative to the other sites for subjects reporting pain. These findings suggest that shuntodynia pain arises in the scalp tissue around the implanted shunts and may be caused due to hypoxia and inflammation.Conclusions: Optically derived hemodynamic variables were statistically significantly different in subjects presenting with shuntodynia relative to those without. DRS could provide a viable mode in routine bedside monitoring of subjects with VP shunts for clinical management and assessment of shuntodynia.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Can diffuse reflectance spectroscopy identify shuntodynia in pediatric hydrocephalus patients?

Kline,

Vishwanath,

Colbrunn

et al. 2024

J. Biomed. Opt.

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Can diffuse reflectance spectroscopy identify shuntodynia in pediatric hydrocephalus patients?

Kline,

Vishwanath,

Colbrunn

et al. 2023

Preprint

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Significance: Shuntodynia is patient reported pain at the site of the implanted ventriculo-peritoneal (VP) shunt. Pediatric hydrocephalus requiring shunt placement is a chronic and prevalent standard of care treatment and requiring lifetime management. Shuntodynia is a subjective measure of shunt dysfunction. Quantitative, white-light tissue spectroscopy could be used to objectively identify this condition in the clinic. Aim: Pediatric subjects were recruited for optical sensing during routine clinical follow-up visits, post VP shunt implantations. Acquired optical signals were translated into skin-hemodynamic signatures and were compared between subjects that reported shuntodynia vs. those that did not. Approach: Diffuse reflectance spectroscopy (DRS) measurements were collected between 450-700 nm using a single-channel fiber-optical probe from (N=35) patients. Multiple reflectance spectra were obtained by the attending physician from regions both proximal and distal to the VP shunt sites, and from a matched contralateral site for each subject. Acquired reflectance spectra were processed quantitatively into functional tissue optical endpoints. A two-way, repeated measures analysis of variance (ANOVA) was used to assess whether and which of the optical variables were statistically separable, across subjects with shuntodynia vs. those without. Results: Results showed that vascular oxygen saturation was significantly lower in subjects reporting shuntodynia, when measured proximal to shunt sites. Subjects with shuntodynia also had lower total hemoglobin at the shunt site relative to distal sites. Both patient groups showed higher tissue scattering at the shunt sites in comparison to the contralateral sites. Conclusions: Optically derived hemodynamic variables were statistically significantly different in subjects presenting with shuntodynia relative to those without. DRS could provide a viable mode in routine bedside monitoring of subjects with VP shunts for clinical management and risk assessment of shuntodynia.

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Torticollis as a rare, late complication of VP shunt placement in the pediatric population: a case report

Kalliri,

Krieg,

El Damaty

2024

Childs Nerv Syst

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The role of surgery in relieving calcified shunt site-related pain in patients with functioning VP shunt

Cited by 3 publications

References 11 publications

Can diffuse reflectance spectroscopy identify shuntodynia in pediatric hydrocephalus patients?

Can diffuse reflectance spectroscopy identify shuntodynia in pediatric hydrocephalus patients?

Can diffuse reflectance spectroscopy identify shuntodynia in pediatric hydrocephalus patients?

Torticollis as a rare, late complication of VP shunt placement in the pediatric population: a case report

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