Utilidad de la monitorizacion de la PIC en pacientes con sospecha de disfunción valvular

Horcajadas, A.; Román, A.; Olivares, Gonzalo Quintero; Saura, Enrique García-Barros; Jorques, A.; Cordero, N.; Ibáñez, Borja; Sánchez, C.; Roldán, Minerva Alganza

doi:10.1016/s1130-1473(11)70027-6

Cited by 3 publications

(3 citation statements)

References 25 publications

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“…The type of overdrainage cannot be determined based solely on clinical symptoms [73]. Therefore, ICP monitoring can be a useful tool [74]. Patients with low or high ICP may present with similar symptoms and radiological findings [75] and high ICP values might be present in patients with mild symptoms or even asymptomatic patients [74].…”

Section: Icp Patterns In Shunt Overdrainagementioning

confidence: 99%

“…In early studies, mean ICP rise > 20 and peaks > 50 mmHg were encountered in patients with "intermittent" symptoms [19]. Recently, in overnight ICP monitoring (OIM) studies, ICP recordings showed irregular traces with a mean ICP > 20 mmHg, triangular shape of ICP pulse waveform and an increase in frequency and amplitude of vasogenic waves (B wave storms and recurrent plateau waves) [28,34,74]. An ICP trace can be divided into baseline intervals and wave intervals.…”

Section: Icp Patterns In Shunt Overdrainagementioning

confidence: 99%

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Shunt Overdrainage: Reappraisal of the Syndrome and Proposal for an Integrative Model

Ros

Iglesias

Linares

et al. 2021

JCM

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Although shunt overdrainage is a well-known complication in hydrocephalus management, the problem has been underestimated. Current literature suggests that the topic requires more examination. An insight into this condition is limited by a lack of universally agreed-upon diagnostic criteria, heterogeneity of published series, the multitude of different management options and misunderstanding of relationships among pathophysiological mechanisms involved. We carried out a review of the literature on clinical, radiological, intracranial pressure (ICP), pathophysiological and treatment concepts to finally propose an integrative model. Active prophylaxis and management are proposed according to this model based on determination of pathophysiological mechanisms and predisposing factors behind each individual case. As pathophysiology is progressively multifactorial, prevention of siphoning with gravitational valves or antisiphon devices is mandatory to avoid or minimize further complications. Shunt optimization or transferal and neuroendoscopy may be recommended when ventricular collapse and cerebrospinal fluid isolation appear. Cranial expansion may be useful in congenital or acquired craniocerebral disproportion and shunting the subarachnoid space in communicating venous hydrocephalus and idiopathic intracranial hypertension.

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Section: Icp Patterns In Shunt Overdrainagementioning

confidence: 99%

Section: Icp Patterns In Shunt Overdrainagementioning

confidence: 99%

Shunt Overdrainage: Reappraisal of the Syndrome and Proposal for an Integrative Model

Ros

Iglesias

Linares

et al. 2021

JCM

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“…Evaluation of IVP dynamics clearly demonstrated the influence of body position on CSF drainage in hydrocephalic human adults. [42][43][44][45][46][47] Higher CSF draining was associated with a standing position and the addition of the hydrostatic pressure in the shunt system to IVP that in sum act on the valve's resistance to CSF flow. 48,49 The use of shunts without antisiphoning devices is another major risk factor for overdrainage and hematoma in most human studies.…”

Section: Discussionmentioning

confidence: 99%

Risk factors, treatment, and outcome in dogs and cats with subdural hematoma and hemispheric collapse after ventriculoperitoneal shunting of congenital internal hydrocephalus

Farke,

Siwicka,

Olszewska

et al. 2023

Veterinary Internal Medicne

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BackgroundOvershunting and hemispheric collapse are well‐known complications after ventriculoperitoneal shunt (VPS) implantation. Risk factors that predispose to overshunting, treatment options, and prognosis after therapeutic intervention have not been described.Hypothesis/ObjectivesTo identify preoperative risk factors for overshunting, the effect of surgical decompression, and their outcomes.AnimalsSeventy‐five dogs and 7 cats.MethodsRetrospective case cohort study. Age, breed, sex, body weight, number of dilated ventricles, ventricle brain ratio, intraventricular pressure, and implanted pressure valve systems were evaluated as possible risk factors.ResultsOvershunting had a prevalence of 18% (Cl 95% 9.9‐26.66). An increase of 0.05 in VBR increased the risk of overshunting by OR 2.23 (Cl 95% 1.4‐3.5; P = .001). Biventricular hydrocephalus had the highest risk for overshunting compared to a tri‐ (OR 2.48 with Cl 95% 0.5‐11.1) or tetraventricular hydrocephalus (OR 11.6 with Cl 95% 1.7‐81.1; P = .05). There was no influence regarding the use of gravitational vs differential pressure valves (P > .78). Overshunting resulted in hemispheric collapse, subdural hemorrhage, and peracute deterioration of neurological status in 15 animals. Subdural hematoma was removed in 8 dogs and 2 cats with prompt postoperative improvement of clinical signs.Conclusions and Clinical ImportanceBiventricular hydrocephalus and increased VBR indicate a higher risk for overshunting. The use of differential valves with gravitational units has no influence on occurrence of overshunting related complications and outcomes. Decompressive surgery provides a favorable treatment option for hemispheric collapse and has a good outcome.

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B waves: a systematic review of terminology, characteristics, and analysis methods

Martinez-Tejada

Arum

Wilhjelm

et al. 2019

Fluids Barriers CNS

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Background Although B waves were introduced as a concept in the analysis of intracranial pressure (ICP) recordings nearly 60 years ago, there is still a lack consensus on precise definitions, terminology, amplitude, frequency or origin. Several competing terms exist, addressing either their probable physiological origin or their physical characteristics. To better understand B wave characteristics and ease their detection, a literature review was carried out. Methods A systematic review protocol including search strategy and eligibility criteria was prepared in advance. A literature search was carried out using PubMed/MEDLINE, with the following search terms: B waves + review filter, slow waves + review filter, ICP B waves, slow ICP waves, slow vasogenic waves, Lundberg B waves, MOCAIP. Results In total, 19 different terms were found, B waves being the most common. These terminologies appear to be interchangeable and seem to be used indiscriminately, with some papers using more than five different terms. Definitions and etiologies are still unclear, which makes systematic and standardized detection difficult. Conclusions Two future lines of action are available for automating macro-pattern identification in ICP signals: achieving strict agreement on morphological characteristics of “traditional” B waveforms, or starting a new with a fresh computerized approach for recognition of new clinically relevant patterns.

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Utilidad de la monitorizacion de la PIC en pacientes con sospecha de disfunción valvular

Cited by 3 publications

References 25 publications

Shunt Overdrainage: Reappraisal of the Syndrome and Proposal for an Integrative Model

Shunt Overdrainage: Reappraisal of the Syndrome and Proposal for an Integrative Model

Risk factors, treatment, and outcome in dogs and cats with subdural hematoma and hemispheric collapse after ventriculoperitoneal shunting of congenital internal hydrocephalus

B waves: a systematic review of terminology, characteristics, and analysis methods

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