Shunting with gravitational valves—can adjustments end the era of revisions for overdrainage-related events?

Freimann, Florian Baptist; Sprung, Christian

doi:10.3171/2012.8.jns1233

Cited by 32 publications

(14 citation statements)

References 26 publications

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“…Moreover, children cannot always express changes in symptoms clearly and their carers may not be able to provide reliable information, adding to the difficulty of the diagnosis. The immediate reduction in the optic nerve sheath diameter after cerebrospinal fluid drainage suggests that this method may be a useful tool in the peri‐operative management of children with hydrocephalus; it may, in addition, contribute to establishing the appropriate pressure for the surgeon to set the valve in the shunt, thus avoiding overdrainage .…”

Section: Discussionmentioning

confidence: 99%

Ultrasonography of the optic nerve sheath to assess intracranial pressure changes after ventriculo‐peritoneal shunt surgery in children with hydrocephalus: a prospective observational study

et al. 2015

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SummaryThe optic nerve sheath diameter has been verified by various clinical studies as a non-invasive indicator of intracranial hypertension. The aim of this study was to compare the optic nerve sheath diameter before and immediately after ventriculo-peritoneal shunt surgery in children with hydrocephalus. We analysed transorbital ultrasonographic images recorded after induction of anaesthesia and 30 min after shunt insertion in 34 children, measuring the optic nerve sheath diameters using a linear ultrasound probe. The mean (SD) optic nerve sheath diameters were 5.4 (0.6) mm (right) and 5.3 (0.7) mm (left) before surgery and 4.4 (0.5) mm (right) and 4.5 (0.7) mm (left) after surgery (p < 0.0001 for before and after comparisons for both eyes). The technique allows rapid and non-invasive assessment of intracranial pressure to guide appropriate postoperative management.

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Section: Discussionmentioning

confidence: 99%

Ultrasonography of the optic nerve sheath to assess intracranial pressure changes after ventriculo‐peritoneal shunt surgery in children with hydrocephalus: a prospective observational study

et al. 2015

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“…Over drainage is an infrequent complication of a functioning CSF shunt, but the risk increases when the patient is upright [9]. Over drainage usually manifests as an orthostatic headache caused by intracranial hypotension, slit-like ventricle syndrome, hygroma, or subdural hematoma [10]. However, in hydrocephalus patients who have undergone a previous decompressive craniectomy, the incidence of overdrainage after CSF diversion increases significantly due to atmospheric pressure.…”

Section: Discussionmentioning

confidence: 99%

Overdrainage after ventriculoperitoneal shunting in a patient with a wide depressed skull bone defect: The effect of atmospheric pressure gradient

Zhou

Sun

et al. 2016

International Journal of Surgery Case Reports

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HighlightsPostoperative hydrocephalus is a frequent complication requiring cerebrospinal fluid (CSF) diversion. It is so complicated in the patient who had a wide decompressive craniectomy.We herein emphasize the efficacy of VP shunting, supine bed rest and cranioplasty in treating hydrocephalus patients who have undergone craniectomy.The gravitational effect and the atmospheric pressure gradient effect are two factors associated in the treatment of hydrocephalus for the patient who had decompressive craniectomy. These effects can be eliminated by supine bed rest and cranioplasty.

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“…Shunt revision rate was similar in both cases [9]. Although no significant difference in the incidence of subdural fluid collections between the programmable and fixed-pressure valve treatment groups was found, a programmable valve gives the surgeon the benefit to adjust the opening pressure setting noninvasively, according to clinical or radiological findings, during the postoperative period [7, 10]. In addition shunt system with programmable valve allows for continued treatment of the patient's known hydrocephalic condition.…”

Section: Discussionmentioning

confidence: 99%

The Value of Programmable Shunt Valves for the Management of Subdural Collections in Patients with Hydrocephalus

Pachatouridis

Alexiou

Mihos

et al. 2013

The Scientific World Journal

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Background. The aim of the present study was to assess the value of electromagnetic programmable shunt valves for the treatment of subdural collections. Methods. Adult patients with hydrocephalus of various causes that were treated with programmable shunt valves during the last ten years were retrospectively studied. In 127 patients, 139 electromagnetic programmable shunt valves were implanted. Results. A nontraumatic subdural fluid collection was detected in 12 patients. The treatment of these patients consisted of reprogramming of the valve's opening pressure. In 5 patients small subdural hematomas were detected; 4 of these patients were treated by raising the opening pressure alone and one patient required surgical drainage and change of the pressure setting. Traumatic chronic subdural hematomas were detected in 6 patients. These patients were treated by surgical drainage and readjustment of the valve's opening pressure. Conclusion. The ability to treat a shunt-related complication, such as a subdural fluid collection, by reprogramming the valve's opening pressure to a higher setting is an advantage over nonprogrammable valves, and it enables the opening pressure to be slowly lowered once the fluid collection is reabsorbed. Based on our results, we believe that programmable shunt valves should be preferred.

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Shunting with gravitational valves—can adjustments end the era of revisions for overdrainage-related events?

Cited by 32 publications

References 26 publications

Ultrasonography of the optic nerve sheath to assess intracranial pressure changes after ventriculo‐peritoneal shunt surgery in children with hydrocephalus: a prospective observational study

Ultrasonography of the optic nerve sheath to assess intracranial pressure changes after ventriculo‐peritoneal shunt surgery in children with hydrocephalus: a prospective observational study

Overdrainage after ventriculoperitoneal shunting in a patient with a wide depressed skull bone defect: The effect of atmospheric pressure gradient

The Value of Programmable Shunt Valves for the Management of Subdural Collections in Patients with Hydrocephalus

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