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To evaluate the benefit of surgical shunt removal or externalization followed by removal, Wong et al. compared two groups: one with medical treatment alone, and another with medical and surgical treatment simultaneously. 28 patients with infection after ventriculoperitoneal shunt implantation over an 8-year period in their neurosurgical center ...
An external ventricular drain (EVD), also known as a ventriculostomy or extraventricular drain, is a device used in neurosurgery to treat hydrocephalus and relieve elevated intracranial pressure when the normal flow of cerebrospinal fluid (CSF) inside the brain is obstructed.
When catheter drainage is permanent, it is usually referred to as a shunt. There are many catheter-based ventricular shunts that are named for where they terminate, for example, a ventriculoperitoneal shunt terminates in the peritoneal cavity, a ventriculoatrial shunt terminates within the atrium of the heart, etc.
A shunt has risk of infection and failure for which subsequent surgery is needed. Complications of ETV include hemorrhage (the most severe being due to basilar artery rupture), injury to neural structures (e.g. hypothalamus, pituitary gland or fornix of the brain), and late sudden deterioration. [3]
Shunt surgery was introduced in 1949; initially, ventriculoperitoneal shunts were used. In 1971, good results were reported with lumboperitoneal shunting. Negative reports on shunting in the 1980s led to a brief period (1988–1993) during which optic nerve fenestration (which had initially been described in an unrelated condition in 1871) was ...
The shunt also has a valve which serves to maintain one-way flow of the CSF and regulates the flow rate. The end with the catheter is placed in the third ventricle to drain the excess CSF and the other end is placed in the peritoneal cavity or atrium of the heart (making it a ventriculoperitoneal or ventriculoatrial shunt, respectively). The ...
For example, it may be required for a patient with a lumbar–peritoneal shunt, if multiple revisions are required or overdrainage is occurring, to have it replaced with a ventriculo–peritoneal shunt (VP shunt). Shunt revisions are required due to the following complications: Over drainage; Under drainage; Infection; Blockage or obstruction
Following the bidirectional Glenn shunt, failure of the procedure can be broadly categorized as failure of procedure, cardiac dysfunction related to surgery, or cardiac dysfunction leading to death before further surgical intervention. [8] Retrospective reviews demonstrate failure of the procedure in 6.5% of patients.