Randomized Trial of Cerebrospinal Fluid Shunt Valve Design in Pediatric Hydrocephalus

Drake, James M.; Kestle, John R. W.; Milner, Ruth; Cinalli, Giuseppe; Boop, Frederick A.; Piatt, Joseph H.; Haines, Stephen J.; Schiff, Steven J.; Cochrane, D. Douglas; Steinbok, Paul; MacNeil, Nancy

doi:10.1097/00006123-199808000-00068

Cited by 646 publications

(401 citation statements)

References 16 publications

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“…An infection rate of 19.5% was found in the present study. This value is high but is still within the rates reported in the literature which range from 3 to 30% 2,3 .…”

Section: Discussionsupporting

confidence: 81%

“…Analysis of the relationship between age and complications showed a significantly higher rate of infection (p=0.001) among children older than 2 years (Table 3), a finding that is in contrast to literature data 2,3 .…”

Section: Resultscontrasting

confidence: 64%

“…lima et al 4 reported a surgical infection rate of 27.6% (16/58) per surgical procedure and of 32% (16/50) per patient, with about 80% of cases being diagnosed within the first postoperative month. since the present patients were only studied for a short period of time, our infection rate is probably higher than reported in that study 3 . however, in view of the difficulties encountered at Brazilian public hospitals and considering a value of 10% observed in patients with primary hydrocephalus, this rate is within an acceptable, although not ideal, limit 5 .…”

Section: Discussioncontrasting

confidence: 60%

“…Infection rates are much higher in these patients than in those with congenital hydrocephalus because the former normally require a longer period of hospitalization and many of them develop other clinical complications such as pneumonia and urinary infection which markedly increase the risk of vP shunt infections 2,3 . According to the literature, 70 to 80% of shunt infections occur within the first postoperative month and 15% occur from the first to the ninth postoperative month 4 .…”

Section: Discussionmentioning

confidence: 99%

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Early shunt complications in 46 children with hydrocephalus

Braga

Carvalho

Brandão

et al. 2009

Arq. Neuro-Psiquiatr.

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-Objective: To determine the causes of early shunt complications in 46 children with hydrocephalus. Method: A retrospective study was conducted on 46 children submitted to ventriculoperitoneal shunt surgery between February 2005 and February 2007. Results: Thirteen (28%) patients presented complications, which were due to infection in 9 (69%) and to malfunction of the shunt system in 4 (31%).The mean number of surgical procedures performed on patients who presented complications was 2.8 per patient, with a total of 46 surgeries in this group. All patients with infectious complications were identified during their hospital stay. Conclusions: Infection was the most common complication. The infection rate was proportional to the length of hospital stay. All patients with hydrocephalus due to tumors or myelomeningocele presented complications. A higher incidence of infections was observed in children older than 2 years.Key words: hydrocephalus, hydrocephalus valve, ventriculoperitoneal shunt, ventriculoatrial shunt, early complications.complicações precoces de válvula de hidrocefalia em 46 crianças resumo -Objetivo: determinar e as causas das complicações precoces nas válvulas de hidrocefalia de 46 crianças. Método: Um estudo retrospectivo foi realizado com 46 crianças submetidas a colocação de válvula de hidrocefalia no período de fevereiro de 2005 a fevereiro de 2007. Resultados: obtivemos 13 (28%) pacientes com complicações sendo 9 (69%) causadas por infecção e 4 (31%) por mal funcionamento da válvula de hidrocefalia. A média de procedimentos cirúrgicos realizados nos pacientes com complicações foi de 2,8 por paciente, sendo o total de 46 cirurgias neste grupo. Todos os pacientes com complicações infecciosas foram detectados durante a internação hospitalar. Conclusões: Infecção foi a complicação mais comum. o índice de infecção foi proporcional ao tempo de permanência hospitalar. Todos os pacientes portadores de hidrocefalia secundária a tumores ou mielomeningocele complicaram. As crianças maiores de 2 anos de idade tiveram maior incidência de infecções.PAlAvrAs-chAve: hidrocefalia, válvula de hidrocefalia, derivação ventrículo-peritoneal, derivação ventrículo-atrial, complicações precoces. department of Neurosurgery, santa casa de Belo horizonte, Belo horizonte MG, Brazil: 1 resident of Neurosurgery; 2 staff Neurosurgeon.

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“…An infection rate of 19.5% was found in the present study. This value is high but is still within the rates reported in the literature which range from 3 to 30% 2,3 .…”

Section: Discussionsupporting

confidence: 81%

Section: Resultscontrasting

confidence: 64%

Section: Discussioncontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

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Early shunt complications in 46 children with hydrocephalus

Braga

Carvalho

Brandão

et al. 2009

Arq. Neuro-Psiquiatr.

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“…In such cases, the failure rate of ventriculoperitoneal shunts has been described in up to 35-40 % of patients [138]. Kellnar et al were the first to pioneer endoscopic-aided catheter placements in 1995, which have since been reproduced successfully for the placement of ventricular catheters and shunts in a wide variety of settings.…”

Section: Endoscopic-assisted Catheter Placementmentioning

confidence: 99%

Ventricular endoscopy in the pediatric population: review of indications

et al. 2014

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Introduction Neuroendoscopy has greatly impacted pediatric neurosurgery over the past few decades. Improved optics and microsurgical tools have allowed neuroendoscopes to be used for a multitude of neurosurgical procedures. Discussion In this review article, we present the breadth of intraventricular neuroendoscopic procedures for the treatment of conditions ranging from hydrocephalus and brain tumors to congenital cysts and other pathologies. We critically discuss treatment indications and reported success rates for neuroendoscopic procedures. We also present novel approaches, technical nuances, and variations from recently published literature and as practiced in the authors' institution.

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Use of Fetal Magnetic Resonance Image Analysis and Machine Learning to Predict the Need for Postnatal Cerebrospinal Fluid Diversion in Fetal Ventriculomegaly

et al. 2018

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IMPORTANCE Which children with fetal ventriculomegaly, or enlargement of the cerebral ventricles in utero, will develop hydrocephalus requiring treatment after birth is unclear. OBJECTIVE To determine whether extraction of multiple imaging features from fetal magnetic resonance imaging (MRI) and integration using machine learning techniques can predict which patients require postnatal cerebrospinal fluid (CSF) diversion after birth.

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Randomized Trial of Cerebrospinal Fluid Shunt Valve Design in Pediatric Hydrocephalus

Abstract: Cerebrospinal fluid shunt failure, predominantly from shunt obstruction and infection, remains a persistent problem in pediatric hydrocephalus. Two new valve designs did not significantly affect shunt failure rates.

Cited by 646 publications

References 16 publications

Early shunt complications in 46 children with hydrocephalus

Early shunt complications in 46 children with hydrocephalus

Ventricular endoscopy in the pediatric population: review of indications

Use of Fetal Magnetic Resonance Image Analysis and Machine Learning to Predict the Need for Postnatal Cerebrospinal Fluid Diversion in Fetal Ventriculomegaly

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