Peritoneal cerebrospinal fluid shunt insertion: a technique for protection of the abdominal catheter

1995 ◽  
Vol 82 (2) ◽  
pp. 305-306 ◽  
Author(s):  
Joseph H. Piatt

✓ A minor modification of the technique of peritoneal cerebrospinal fluid shunt insertion allows more anatomical closure of the abdominal wound and may protect the shunt from contamination by superficial abdominal wound infection.

1981 ◽  
Vol 54 (2) ◽  
pp. 257-260 ◽  
Author(s):  
Rodger Fagerburg ◽  
Byungse Shu ◽  
Helen R. Buckley ◽  
Bennett Lorber ◽  
John Karian

✓ A 57-year-old woman underwent ventriculoperitoneal shunt placement for noncommunicating hydrocephalus. She required several shunt revisions over a 2-year period for recurrent hydrocephalus. The shunt was subsequently found to be obstructed by growth of the saprophytic fungus, Paecilomyces variotii, an infrequent human pathogen. Paecilomyces infections have caused complications associated with prosthetic cardiac valves and synthetic lens implantation; this is the first reported association with a cerebrospinal fluid shunt.


1980 ◽  
Vol 52 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Steven L. Wald ◽  
Robert L. McLaurin

✓ Twenty patients with documented cerebrospinal fluid shunt infections were treated with daily intraventricular injections of methicillin, cephalothin, or gentamicin without removal of the shunt or external ventricular drainage. Periodic determinations of intraventricular antibiotic concentration revealed significant levels in relation to the established minimum inhibitory concentration in all cases.


1989 ◽  
Vol 70 (1) ◽  
pp. 143-145 ◽  
Author(s):  
Yusuke Ishiwata ◽  
Yasuhiro Chiba ◽  
Toshinori Yamashita ◽  
Gakuji Gondo ◽  
Kaoru Ide ◽  
...  

✓ Surface cooling and thermistor recording over shunt tubing was used in 23 studies of cerebrospinal fluid shunt patency in 19 patients with lumboperitoneal shunts and normal-pressure hydrocephalus. Shunt patency was shown by downward reflection of the recording trace similar to that obtained for ventriculoperitoneal shunts. Obstruction was demonstrated by a flat-line recording or an upward deflection.


1984 ◽  
Vol 60 (2) ◽  
pp. 361-364 ◽  
Author(s):  
Alvin Kuruc ◽  
Salvador Treves ◽  
Keasley Welch ◽  
Denise Merlino

✓ Flow of cerebrospinal fluid through a surgically implanted valve may be estimated by analyzing the disappearance curve resulting from the injection of a radiotracer into the valve. The standard method for estimating flow assumes an exponential disappearance of the tracer from the valve. This method models the valve as a single well-mixed compartment. Experimental evidence, showing that estimates of flow were dependent upon the site of injection, is at variance with this assumption. An alternative method of analyzing the disappearance curves, based on the area to height ratio (A/H) of the curves, was found to be more consistent with the experimental evidence and resulted in greater precision than the exponential method. It was concluded that optimal results are obtained using the A/H method with a fixed injection technique.


1984 ◽  
Vol 60 (3) ◽  
pp. 644-646 ◽  
Author(s):  
Nicola Di Lorenzo ◽  
Pierpaolo Lunardi ◽  
Aldo Fortuna

✓ The clinical features and pathology of granule cell hypertrophy of the cerebellum (Lhermitte-Duclos disease) are described in a 30-year-old man. The patient, who underwent successful surgery, is the eighth reported survivor of this disease. Whether the disease is neoplastic or dysplastic is still unknown, but the lesion has growth potential, and consequently the proper treatment is surgical resection. A cerebrospinal fluid shunt was only temporarily effective in this case.


1976 ◽  
Vol 44 (5) ◽  
pp. 580-584 ◽  
Author(s):  
E. Dale Everett ◽  
Theodore C. Eickhoff ◽  
Richard H. Simon

✓ The clinical and laboratory findings in six cases of anaerobic diphtheroid infection of cerebrospinal fluid shunts are described. These organisms have been infrequently reported as a cause of shunt infections but our data indicate that such infections may be more common than currently appreciated. Propionibacterium species are common contaminants of cerebrospinal fluid specimens, but when isolated from the spinal fluid of a patient with a shunt who has symptoms and signs compatible with infection, the organism should not be dismissed as a contaminant. Fever was a constant finding frequently accompanied by signs of central nervous system dysfunction. Spinal fluid pleocytosis was usually limited to 1 to 200 cells and protein and sugar values were variable. The organisms grow slowly, therefore spinal fluid cultures should be held for at least 14 days before they are reported as negative.


1979 ◽  
Vol 51 (2) ◽  
pp. 245-246 ◽  
Author(s):  
Ernest B. Visconti ◽  
Georges Peter

✓ The successful use of vancomycin is reported in two children with shunt infections due to Staphylococcus epidermidis which failed to respond to shunt removal. The previously reported experience with this drug is reviewed. The use of vancomycin should be considered in cases of shunt infections due to susceptible micro-organisms and refractory to other therapeutic measures.


1991 ◽  
Vol 75 (4) ◽  
pp. 541-544 ◽  
Author(s):  
Howard Tung ◽  
Corey Raffel ◽  
J. Gordon McComb

✓ To determine the significance of cerebrospinal fluid (CSF) eosinophilia, the charts of 106 patients treated with shunt-related procedures during the calendar year 1985 were reviewed. Sixty-nine patients presented for a shunt revision; their charts were retrospectively reviewed from the time of shunt insertion until January, 1988. The remaining 37 patients had a ventriculoperitoneal shunt inserted during the study period and were subsequently followed to January, 1988. A total of 558 shunt-related procedures were performed on these patients during the study period, with a mean follow-up period of 6.9 years. The infection rate was 3.8%. Eosinophilia was diagnosed when eosinophils accounted for 8% or more of the total CSF white blood cell count. Ventricular CSF eosinophilia occurred in 36 patients sometime during their clinical course. These 36 patients required a mean of 8.5 shunt revisions, while the remaining patients required a mean of 2.5 revisions (p < 0.001). Shunt infections were also more frequent in patients with eosinophilia (p < 0.01). In no case was peripheral eosinophilia or a parasitic infection present. This study demonstrates that CSF eosinophilia is common in children with shunts. Children with this laboratory finding will experience more shunt failures. In addition, the new appearance of eosinophilia in the CSF of a patient with a shunt in place suggests the possibility of a shunt infection.


1975 ◽  
Vol 42 (6) ◽  
pp. 728-730 ◽  
Author(s):  
Marc A. Flitter ◽  
William A. Buchheit ◽  
Frederick Murtagh ◽  
Marc S. Lapayowker

✓ A technique employing a Doppler ultrasound flowmeter in determining cerebrospinal fluid shunt patency is described. The technique has proven to be a valuable aid in the evaluation of the patient in whom shunt function is in question.


1982 ◽  
Vol 57 (5) ◽  
pp. 597-602 ◽  
Author(s):  
Harold J. Hoffman ◽  
E. Bruce Hendrick ◽  
Robin P. Humphreys ◽  
Edward A. Armstrong

✓ Suprasellar arachnoid cysts, although rare, are now being found with increasing frequency with the help of the computerized tomography (CT) scanner. Forty-six cases have been reviewed from the literature, and the authors add eight patients seen at their institution during the past 6 years. This latter group have all been diagnosed by CT scan combined with an injection of metrizamide through an implanted diversionary cerebrospinal fluid shunt. Patients in whom the suprasellar arachnoid cyst had produced hydrocephalus were treated by communicating the cyst with the ventricular system via a transcallosal route, with very satisfactory results.


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