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Infection is a common complication that normally affects pediatric patients because they have not yet built up immunities to a number of different diseases. Normally, the incidence of infection decreases as the patient grows older and the body gains immunity to various infectious agents. [10] Shunt infection can occur in up to 27% of patients.
Cerebrospinal fluid is produced by the choroid plexus in the ventricles of the brain and contained by the dura and arachnoid layers of the meninges. [23] [42] [64] The brain floats in CSF, which also transports nutrients to the brain and spinal cord. As holes form in the spinal dura mater, CSF leaks out into the surrounding space.
Subdural hygromas require two conditions in order to occur. First, there must be a separation in the layers of the Meninges of the brain. Second, the resulting subdural space that occurs from the separation of layers must remain uncompressed in order for CSF to accumulate in the subdural space, resulting in the hygroma. [1]
Diagnosis of the particular complication usually depends on when the symptoms appear, that is, whether symptoms occur when the person is upright or in a prone position, with the head at roughly the same level as the feet. [51] Standardized protocols for inserting cerebral shunts have been shown to reduce shunt infections.
It is typically caused by a basilar skull fracture, which presents complications such as infection. It may be diagnosed using brain scans (prompted based on initial symptoms), and by testing to see if discharge from the nose is cerebrospinal fluid. Treatment may be conservative (as many cases resolve spontaneously), but usually involves ...
The pressure in the brain does not get high enough to allow the cerebrospinal fluid to drain in a shunt system, therefore the shunt is open, but malfunctioning in LPH. In cases of LPH, chronic infarcts can also develop along the corona radiata in response to the tension in the brain as the ventricles increase in size.
However, it can also be used to detect other forms of right-to-left shunts including pulmonary arteriovenous malformations because it too needs agitated saline/contrast injected, but rather than imaging the heart, observes if any microemboli appear in the middle cerebral artery, an artery or the brain, following a valsalva maneuver.
Surgical placement of a cerebral shunt: [25] An internal shunt drains into the subdural compartment. [26] A cystoperitoneal shunt drains to the peritoneal cavity. [27] Fenestration: Craniotomy with excision [28] Various endoscopic techniques are proving effective, [29] including laser-assisted techniques. [30] Drainage by needle aspiration or ...