Letter to the Editor Regarding “Diagnosis of Ventriculoperitoneal Shunt Malfunction: A Practical Algorithm”

Truffelli, Monica; Ceraudo, Marco; Cavelli, Marcella; Prior, Alessandro; Balestrino, Alberto; Fiaschi, Pietro

doi:10.1016/j.wneu.2020.05.133

Cited by 9 publications

(4 citation statements)

References 4 publications

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“…In addition, the so-called secondary ETV should play a role if a ventriculoperitoneal shunt malfunction is present, even after decades of shunting [64]. As reported by Waqar, for aqueductal stenosis and tumours, there was no significant difference in success rate between primary and secondary ETV [68].…”

Section: Pre-resection Etvmentioning

confidence: 90%

“…Currently, taking inspiration from data on persistent hydrocephalus after tumour resection (that range from 5 to 33%) [6,22,39,42,48,51,62], pre-resection CSF diversion (EVD, ETV, VPS) is more criticised than in the past. Shunt infection ranges from 1.2 to 19% [6, 13, 14, 23, 24, 28, 31, 36-39, 47, 50, 56, 62, 63] and has been correlated with mortality [64,65]. Intratumoural haemorrhage and upward tentorial herniation following CSF shunting before posterior fossa tumour removal have also been reported [14,16,43,53,67,71].…”

Section: Pre-resection Csf Shunt: Advantages and Disadvantagesmentioning

confidence: 99%

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The role of external ventricular drainage for the management of posterior cranial fossa tumours: a systematic review

et al. 2020

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Posterior cranial fossa tumours frequently develop hydrocephalus as first presentation in up to 80% of paediatric patients and 21.4% of adults, although it resolves after tumour removal in 70-90% and 96%, respectively. New onset hydrocephalus is reported in about 2.1% of adult and 10-40% of paediatric patients after posterior fossa surgery. There is no consensus concerning prophylactic external ventricular drainage (EVD) placement that is frequently used before posterior fossa lesion removal, as well in those cases without clear evidence of hydrocephalus. The aim of the study was to define the most correct management for patients who undergo posterior fossa tumour surgery, thus identifying cohorts of patients who are at risk of persistent hydrocephalus prior to surgery. A systematic review of literature has been performed, following PRISMA guidelines. Most of the studies reported CSF shunt only in the presence of hydrocephalus, whereas only a few authors suggested its prophylactic use in the absence of signs of ventricular dilatation. Predictive factors for postoperative hydrocephalus has been identified, including young age (< 3 years), severe symptomatic hydrocephalus at presentation, EVD placement before surgery, FOHR index > 0.46 and Evans index > 0.4, pseudomeningocele, CSF leak and infection. The use of pre-resection CSF shunt in case of signs and symptoms of hydrocephalus is mandatory, although it resolves in the majority of cases. As reported by several studies included in the present review, we suggest CSF shunt also in case of asymptomatic hydrocephalus, whereas it is not indicated without evidence of ventricular dilatation.

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Section: Pre-resection Etvmentioning

confidence: 90%

Section: Pre-resection Csf Shunt: Advantages and Disadvantagesmentioning

confidence: 99%

The role of external ventricular drainage for the management of posterior cranial fossa tumours: a systematic review

et al. 2020

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“…As the authors stated, despite advances in surgical techniques and shunting technology, CSF shunt may be associated with several complications and long-term sequelae, 6 , 7 , 8 and malfunctioning is still one of the most usual complications in shunted hydrocephalus or cysts both in adults or pediatric population. 9 , 10 …”

mentioning

confidence: 99%

“…Furthermore, other practical algorithms for VPS malfunction to establish the exact level at which the shunt failed has been proposed, 8 even in complex situations, such as in asymptomatic cases or in the presence of slit ventricle syndrome. 7 …”

mentioning

confidence: 99%

Letter to the Editor Regarding, “Shunt Valve Rupture: An Interesting Case Report of Ventriculoperitoneal Shunt Failure”

Ceraudo

Prior

2020

World Neurosurgery

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Subduro-peritoneal shunts in the management of subdural collection related to ruptured intracranial arachnoid cysts

Ceraudo

Prior

2020

Childs Nerv Syst

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Letter to the Editor Regarding “Diagnosis of Ventriculoperitoneal Shunt Malfunction: A Practical Algorithm”

Cited by 9 publications

References 4 publications

The role of external ventricular drainage for the management of posterior cranial fossa tumours: a systematic review

The role of external ventricular drainage for the management of posterior cranial fossa tumours: a systematic review

Letter to the Editor Regarding, “Shunt Valve Rupture: An Interesting Case Report of Ventriculoperitoneal Shunt Failure”

Subduro-peritoneal shunts in the management of subdural collection related to ruptured intracranial arachnoid cysts

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