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Neuroinfectious Diseases
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Jeremy D. Young, Jesica A. Herrick, Scott Borgetti
A ventriculoperitoneal (VP) shunt, using the peritoneum as the terminating site, is most common, but CSF shunts can also be placed into the pleural space (ventriculopleural shunts) or vascular space (ventriculoatrial shunt). CSF shunt infections range from superficial, involving the skin and soft tissues around the shunt valve, to more invasive with infection of the peritoneum, pleura, vascular space, and/or CNS.
Ofloxacin
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Ofloxacin in combination with amikacin is effective treatment for sternotomy wound infections due to M. fortuitum if strains are ofloxacin susceptible (Yew et al., 1989a, Yew et al., 1989b, Yew et al., 1990b). Although monotherapy with ofloxacin was also successful in the treatment of these sternotomy infections, it is currently not recommended because of the high risk of mutational resistance to fluoroquinolones (Wallace et al., 1997). Combination oral ofloxacin plus systemic and intraventricular amikacin has also been used to cure a ventriculoatrial shunt infection due to M. fortuitum (Chan et al., 1991).
Examination of the Nervous System
Published in Julian L Burton, Guy Rutty, The Hospital Autopsy, 2010
The head should be supported by resting the occiput on a block such that the neck is slightly flexed. The operator should wear appropriate personal protective clothing including protection of eyes. The head and neck should be inspected for any operation scars, contusions or lacerations. Ventricular shunts for the treatment of hydrocephalus are best explored before the cranium is opened. The tube is exposed either in the subcutaneous tissues or, in the case of a ventriculoatrial shunt, in the internal jugular vein. After cutting the tube the patency of the proximal and distal parts can be tested with a syringe and water.
Ventriculo-peritoneal shunting is a safe and effective treatment for idiopathic intracranial hypertension
Published in British Journal of Neurosurgery, 2019
Anna Bjornson, Ian Tapply, Eva Nabbanja, Afrodite-Despina Lalou, Marek Czosnyka, Zofia Czosnyka, Brinda Muthusamy, Matthew Garnett
Image guidance with electromagnetic (EM) navigation was used in all patients and the procedure was performed by a consultant neurosurgeon in all cases. Standard operating procedures were used. The majority of patients (21/28) received an antibiotic impregnated catheter, 3 patients had been recruited into the BASICS trial8 and were randomised to an antibiotic impregnated or silver-lined catheter, and 3 patients had no record of type of catheter. Twenty-six patients received an Orbis Sigma valve and 2 patients received a programmable Strata valve. 1 patient received a ventriculoatrial shunt due to issues with the pleural and peritoneal cavities, the other patients received a ventriculoperitoneal shunt. Right frontal ventricular access was used in twenty-seven of the patients and one patient received a parietal ventricular catheter. (Table 1)
Self-Reported Executive Dysfunction, Fatigue, and Psychological and Emotional Symptoms in Physically Well-Functioning Long-Term Survivors of Pediatric Brain Tumor
Published in Developmental Neuropsychology, 2019
Anita Puhr, Ellen Ruud, Vicki Anderson, Bernt Johan Due-Tønnesen, Anne-Britt Skarbø, Arnstein Finset, Stein Andersson
Information on tumor histology, location, age at diagnosis, and type of treatment was gathered from patient records at the respective treatment institutions. The third version of the International Classification of Childhood Cancer (ICCC-3) was used to classify participants into larger diagnostic subgroups. Postoperative seizures were registered as yes/no if the patient had suffered ≥1 seizure after tumor surgery. Postoperative hydrocephalus was similarly registered as yes/no, i.e., the patient was treated with either ventriculoatrial shunt (VA), ventriculperitoneal shunt (VP), or third ventriculostomy (3CVS). Lastly, hormone replacement treatment was registered as yes/no, e.g., treatment with growth hormones, cortisol, thyroid stimulating hormones, testosterone and estrogen, or antidiuretic hormones. Psychiatric comorbidity as classified by the International Classification of Disease −10 (ICD-10) codes F01-F99 was registered as yes/no. Clinical characteristics of the PBT survivor group are presented in Table 1.
Cross my heart: ventriculoatrial shunt migration into the pulmonary arteries
Published in British Journal of Neurosurgery, 2023
Laura Torres-Brunet, Jordi Pérez-Bovet, Carlos Cohn Reinoso, M. Carme Joly Torta, Jordi Rimbau-Muñoz
A 53 year-old female with a diagnosis of Dandy-Walker malformation was treated with a ventriculoatrial shunt. Seven years later she presented diplopia and gait instability. A brain MRI showed increased ventricular size. Chest X-ray showed a breakage of the distal catheter at the right clavicular level. Thoracic CT scan confirmed the interruption and demonstrated the migration of the distal catheter into both pulmonary arteries (Figure 1). The patient had no respiratory or cardiovascular symptoms. The distal catheter was successfully removed by an endovascular procedure, and the system was converted into a ventriculo-peritoneal shunt.