92 results match your criteria Ventriculoperitoneal Shunt Tap


Gait apraxia evaluation in normal pressure hydrocephalus using inertial sensors. Clinical correlates, ventriculoperitoneal shunt outcomes, and tap-test predictive capacity.

Fluids Barriers CNS 2022 Jun 23;19(1):51. Epub 2022 Jun 23.

Unit of Neurosurgery, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.

Background: Idiopathic normal pressure hydrocephalus (iNPH) is a neurological condition with gait apraxia signs from its early manifestation. Ventriculoperitoneal shunt (VPS) is a surgical procedure available for treatment. The Cerebrospinal fluid Tap Test (CSF-TT) is a quick test used as selection criterion for VPS treatment. Read More

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Candida Shunt Infection Causing Arachnoiditis and Hydrocephalus: A Case Report.

Cureus 2022 Mar 31;14(3):e23675. Epub 2022 Mar 31.

Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, USA.

Arachnoiditis is a relatively rare condition and can result in long-term chronic and debilitating complications if not diagnosed early and treated properly. However, diagnosis of arachnoiditis is rare and knowledge of potential causes of this condition is still sparse. Current known causes of arachnoiditis include infections, trauma, spinal tumors, and iatrogenic causes induced via neurological interventions. Read More

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Evaluation of Surgical Treatment Effect on Idiopathic Normal Pressure Hydrocephalus.

Front Surg 2022 7;9:856357. Epub 2022 Apr 7.

Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China.

Background: We aimed to observe the long-term effectiveness and safety of the ventriculoperitoneal (VP) shunt in treating idiopathic normal pressure hydrocephalus (iNPH).

Methods: A total of 65 patients with iNPH were retrospectively analyzed. All the patients were treated with VP shunt and the clinical efficacy was assessed using follow-up questionnaire, the Modified Rankin Scale (mRS), and iNPH grading scale (iNPHGS) after operation. Read More

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Reconsidering Ventriculoperitoneal Shunt Surgery and Postoperative Shunt Valve Pressure Adjustment: Our Approaches Learned From Past Challenges and Failures.

Front Neurol 2021 6;12:798488. Epub 2022 Jan 6.

Department of Neurosurgery, Shiga University of Medical Science, Shiga, Japan.

Treatment for idiopathic normal pressure hydrocephalus (iNPH) continues to develop. Although ventriculoperitoneal shunt surgery has a long history and is one of the most established neurosurgeries, in the 1970s, the improvement rate of iNPH triad symptoms was poor and the risks related to shunt implantation were high. This led experts to question the surgical indication for iNPH and, over the next 20 years, cerebrospinal fluid (CSF) shunt surgery for iNPH fell out of favor and was rarely performed. Read More

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January 2022

Comparison of comfortable and maximum walking speed in the 10-meter walk test during the cerebrospinal fluid tap test in iNPH patients: A retrospective study.

Clin Neurol Neurosurg 2022 01 23;212:107049. Epub 2021 Nov 23.

Department of Neurology, Nara Prefecture General Medical Center, Nara, Japan.

Background: The 10-meter walking test (10 MWT) is widely used during a cerebrospinal fluid tap test (CSFTT) for idiopathic normal-pressure hydrocephalus (iNPH). However, various previous studies and guidelines do not specify whether to adopt a comfortable walking speed or maximum walking speed when implementing the 10 MWT. In this study, we analyzed the values of comfortable and maximum walking speeds during the CSFTT in patients who underwent shunt surgery to determine which walking form is desirable for evaluation. Read More

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January 2022

The low utility of routine cranial imaging after pediatric shunt revision.

J Neurosurg Pediatr 2021 Nov 19:1-7. Epub 2021 Nov 19.

1Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

Objective: Postoperative routine imaging is common after pediatric ventricular shunt revision, but the benefit of scanning in the absence of symptoms is questionable. In this study, the authors aimed to assess how often routine scanning results in a change in clinical management after shunt revision.

Methods: The records of a large, tertiary pediatric hospital were retrospectively reviewed for all consecutive cases of pediatric shunt revision between July 2013 and July 2018. Read More

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November 2021

Tap Test Can Predict Cognitive Improvement in Patients With iNPH-Results From the Multicenter Prospective Studies SINPHONI-1 and -2.

Front Neurol 2021 2;12:769216. Epub 2021 Nov 2.

Normal Pressure Hydrocephalus Center, Rakuwakai Otowa Hospital, Kyoto, Japan.

We analyzed the predictive value of the tap test (TT) on the outcome of cerebrospinal fluid (CSF) shunting in patients with idiopathic normal pressure hydrocephalus (iNPH) and cognitive impairment up to 12 months postoperatively. We analyzed the data of two prospective multicenter studies on ventriculoperitoneal shunt (VPS) and lumboperitoneal shunt (LPS) use in iNPH patients. We selected patients with Mini-Mental State Examination (MMSE) scores ≤ 26 points as study subjects. Read More

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November 2021

Ventriculoatrial Shunting: An Escape Option in Patients with Idiopathic Normal Pressure Hydrocephalus Failing Ventriculoperitoneal Drainage.

World Neurosurg 2022 01 11;157:e286-e293. Epub 2021 Oct 11.

Department of Neurosurgery, Università Politecnica delle Marche, Azienda Ospedali Riuniti, Ancona, Italy.

Background: Ventriculoperitoneal (VP) shunting is widely accepted as the gold-standard treatment for idiopathic normal pressure hydrocephalus (iNPH). However, a restricted group of patients experience only minimal or no improvement after the operation. In such cases, the question whether the diagnosis was incorrect or the shunt is malfunctioning remains unanswered. Read More

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January 2022

Communicating chronic hydrocephalus: A review.

Rev Med Interne 2021 Nov 16;42(11):781-788. Epub 2021 Jun 16.

Neurosurgery department A, university hospital of Bordeaux, place Amélie-Raba-Léon, Bordeaux, France; Université de Bordeaux, CNRS UMR 5287, INCIA, Zone nord, Bat 2, 2e étage, 146, rue Léo-Saignat, 33076 Bordeaux cedex, France.

Formerly called normal pressure hydrocephalus, communicating chronic hydrocephalus (CCH) is a condition affecting 0.1 to 0.5% of patients over 60years of age. Read More

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November 2021

Preoperative Predictive Factors of Short-Term Outcome in Idiopathic Normal Pressure Hydrocephalus.

World Neurosurg 2021 07 22;151:e399-e406. Epub 2021 Apr 22.

Department of Neurosurgery, Nayoro General Hospital, Nayoro City, Japan.

Background: Surgical treatment of idiopathic normal pressure hydrocephalus (iNPH) by ventriculoperitoneal (VP) or lumboperitoneal (LP) shunting can achieve long-term recovery of activities of daily living; however, in a subset of patients, maintenance of independence lasted for <6 months. This study examined positive preoperative predictive factors of short-term outcome for shunted iNPH patients.

Methods: Over a 9-year period, consecutive patients from multiple centers diagnosed with probable iNPH underwent either VP or LP shunt surgery. Read More

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Cerebral Vasculopathy and Spinal Arachnoiditis: Two Rare Complications of Ventriculitis Post Subarachnoid Hemorrhage.

Cureus 2020 Dec 23;12(12):e12241. Epub 2020 Dec 23.

Neurology, Rush University Medical Center, Chicago, USA.

This report describes a case of subarachnoid hemorrhage complicated by ventriculitis and subsequent delayed cerebral vasospasm, severe chronic spinal arachnoiditis, and Froin syndrome. A 60-year-old woman presented with diffuse aneurysmal subarachnoid hemorrhage and underwent successful coil embolization of ruptured left anterior cerebral artery aneurysm. Her course was complicated by bacterial ventriculitis and acute hydrocephalus necessitating ventriculoperitoneal shunt placement. Read More

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December 2020

Safety of Ventricular Reservoir Sampling in Pediatric Posthemorrhagic Hydrocephalus Patients: Institutional Experience and Review of the Literature.

J Neurosci Nurs 2021 Feb;53(1):11-17

Abstract: INTRODUCTION: Posthemorrhagic hydrocephalus (PHH) is a common disease process encountered in neonates. Management often includes cerebrospinal fluid (CSF) aspiration through ventricular access devices (VADs). However, a common concern surrounding serial access of implanted subcutaneous reservoirs includes introduction of infection. Read More

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February 2021

A comprehensive clinico-radiological, neuropsychological and biomechanical analysis approach to patients with idiopathic normal pressure hydrocephalus.

Clin Neurol Neurosurg 2021 02 4;201:106402. Epub 2020 Dec 4.

Department of Neurology, Academic Teaching Hospital Wels-Grieskirchen, Wels, Austria.

Background: A systematic approach to patients with suspected idiopathic normal pressure hydrocephalus (iNPH) is essential to recognize the subset of patients who may benefit from ventriculoperitoneal shunt surgery (VPS). Quantitative biomechanical analysis of gait and balance (QBAGB) may help objectify the response to the cerebrospinal fluid tap test (CSF-TT) and VPS outcome after 3 months and support identification of candidates for VPS.

Methods: We retrospectively reviewed data from all patients with probable iNPH who 1) underwent clinico-radiological and neuropsychological assessments using validated scales (iNPH Scale and iNPH Radscale) at our centre in the period from January to December 2018; and 2) had completed QBAGB before CSF-TT ('baseline'), shortly after CSF-TT, and at three months after either VPS or conservative treatment. Read More

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February 2021

Acute Presentation of Normal Pressure Hydrocephalus After Transcatheter Aortic Valve Implantation: A Novel Interaction Between the First and Third Circulations.

World Neurosurg 2021 02 9;146:e731-e738. Epub 2020 Nov 9.

Department of Neurosurgery, Beilinson Hospital, Rabin Medical Center, Tel Aviv University, Petah Tikva, Israel.

Background: Idiopathic normal pressure hydrocephalus (iNPH) negatively affects gait and cognition abilities and urine continence in the elderly. It is associated with systemic hypertension, although the exact pathophysiology is still unknown. A correlation to increased intracranial pulsatility and decreased compliance was suggested. Read More

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February 2021

Simulation of proximal catheter occlusion and design of a shunt tap aspiration system.

Childs Nerv Syst 2021 03 7;37(3):895-901. Epub 2020 Oct 7.

Department of Neurosurgery, University of Illinois College of Medicine at Peoria, Peoria, IL, USA.

Purpose: Total and partial proximal catheter occlusions are well-known complications of ventriculoperitoneal shunts (VPS). When this occurs, surgeons often attempt to perform a shunt tap. However, the degree of obstruction in a proximal catheter that ultimately leads to shunt malfunction is unknown. Read More

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High prevalence of cervical myelopathy in patients with idiopathic normal pressure hydrocephalus.

Clin Neurol Neurosurg 2020 10 17;197:106099. Epub 2020 Jul 17.

Department of Neurological Surgery, Mayo Clinic, Rochester, MN, United States; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, United States; Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, United States. Electronic address:

Background: Both idiopathic normal pressure hydrocephalus (iNPH) and cervical myelopathy may result in progressive gait impairment. Some patients who do not respond to shunting despite a positive tap test may have gait dysfunction from cervical myelopathy. The objective of this study was to determine the prevalence of cervical myelopathy in patients with iNPH. Read More

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October 2020

Perioperative Management for Rectal Migration of a Ventriculoperitoneal Shunt.

Ochsner J 2020 ;20(2):239-241

Department of Anesthesiology, Ochsner Clinic Foundation, New Orleans, LA.

While ventriculoperitoneal shunt (VPS) is the most commonly performed surgical procedure for treating hydrocephalus, complications following shunt placement are associated with a high mortality rate. Preoperative medical optimization and surgery are the primary means of correcting shunt migration. We present the case of an 11-week-old patient who underwent emergent surgical intervention for transrectal VPS migration and associated infection. Read More

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January 2020

Global trends in the evaluation and management of cerebrospinal fluid shunt infection: a cooperative ISPN survey.

Childs Nerv Syst 2020 12 9;36(12):2949-2960. Epub 2020 Jun 9.

Department of Neurosurgery, National Children's Hospital of Costa Rica, "Dr. Carlos Saenz Herrera", San José, Costa Rica.

Introduction: Ventriculoperitoneal shunts (VPS) is commonly performed by pediatric neurosurgeons and there is no consensus in management of VPS infection as it relates to diagnosis and treatment.

Objective: We utilized an international practitioner-based survey to study the variability in VPS infection diagnostic and therapeutic measures.

Methods: A survey gauging practice patterns of pediatric neurosurgeons regarding VPS and its complication management was distributed. Read More

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December 2020

Ventriculoperitoneal Shunt Infections Cause Acute Abdomen and Peritonitis: A Case Series.

J Surg Res 2020 04 31;248:153-158. Epub 2019 Dec 31.

Department of Neurosurgery, Klinikum Kassel, Kassel, Germany; Kassel School of Medicine, University of Southampton, Southampton, UK.

Background: Patients with ventriculoperitoneal shunt (VPS) often present to emergency departments with acute abdomen. It is challenging to distinguish between the abdominal problems caused by a VPS and acute surgical abdomen having another cause because VPS infections occasionally cause peritonitis. The frequencies and clinical features of acute abdomen caused by VPS infection are unknown. Read More

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The Outcomes Of Serial Cerebrospinal Fluid Removal In Elderly Patients With Idiopathic Normal Pressure Hydrocephalus.

Clin Interv Aging 2019 19;14:2063-2069. Epub 2019 Nov 19.

Department of Geriatric Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.

Purpose: Elderly patients with iNPH (idiopathic normal pressure hydrocephalus) might be potentially high-risk surgical patients. Our purpose was to investigate the outcome of serial removal of cerebrospinal fluid (CSF) in the patients with iNPH who refused to have the ventriculoperitoneal or lumboperitoneal shunt surgery or had contraindications to them.

Patients And Methods: There were 42 patients, with a median age of 78 years. Read More

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Obstruction of Ventriculoperitoneal Shunt After Myelography-Report of a Unique Case and Its Treatment.

World Neurosurg 2020 Feb 20;134:443-447. Epub 2019 Nov 20.

Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA. Electronic address:

Background: Myelography, frequently supplanted by noninvasive, efficient magnetic resonance imaging, remains a useful technique when evaluating the spinal canal in nerve root avulsion, radiation therapy treatment planning, cerebrospinal fluid (CSF) loculation, and CSF leak. Myelography is achieved through a lumbar puncture and instillation of nonionic, water-soluble intrathecal iohexol (Omnipaque, GE Healthcare, Marlborough, Massachusetts, USA) contrast. The aim of the study was to highlight a possible complication of obstruction of a shunt valve due to an increased viscosity of the CSF after intrathecal Omnipaque contrast administration during myelography. Read More

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February 2020

Abdominal Insufflation Is Associated With Increase of Intracranial Pressure in Patients With Normal Pressure Hydrocephalus.

Oper Neurosurg (Hagerstown) 2020 07;19(1):53-56

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Harvard University, Boston, Massachusetts.

Background: Ventriculoperitoneal shunting (VPS) is effective for the treatment of normal-pressure hydrocephalus (NPH) and sometimes requires laparoscopic assistance with abdominal insufflation.

Objective: To evaluate the association of abdominal insufflation with opening pressure (OP) in NPH patients undergoing VPS implantation.

Methods: Between March 2016 and April 2019, 52 consecutive patients who underwent first-time VPS implantation surgery were retrospectively identified by reviewing electronic health records. Read More

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The Effects of Ventriculoperitoneal Shunt on Gait Performance.

J Med Life 2019 Apr-Jun;12(2):194-198

Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

Most studies on patients with normal pressure hydrocephalus (NPH) regard pre-post Tap test and long-term follow-up after shunt surgery. Quantitative and qualitative assessment tools specific to rehabilitation medicine can provide an objective measurement of the benefit of the neurosurgical intervention at 1-month follow-up. The aim of this retrospective study was to assess the early benefit of the ventriculoperitoneal shunt with low or medium pressure valve on the gait capacity of persons with NPH, one month after surgery. Read More

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November 2019

A prospective evaluation of clinical and instrumental features before and after ventriculo-peritoneal shunt in patients with idiopathic Normal pressure hydrocephalus: The Bologna PRO-Hydro study.

Parkinsonism Relat Disord 2019 09 18;66:117-124. Epub 2019 Jul 18.

Unit of Neurology, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy. Electronic address:

Introduction: Idiopathic Normal Pressure Hydrocephalus (iNPH) is a complex and often misdiagnosed syndrome, whose major challenge is to identify which patients will benefit from surgery. Previous studies reported a variability in positive surgery response. The role of tap test(TT) in screening patients suitable for shunting is controversial. Read More

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September 2019

Normal-pressure hydrocephalus: A critical review.

Dement Neuropsychol 2019 Apr-Jun;13(2):133-143

The Jack S. Blanton Distinguished Endowed Chair, Neurological Institute Houston, Methodist Hospital, Professor of Neurology Weill Cornell Medical College Methodist Neurological Institute, USA.

Normal-pressure hydrocephalus (NPH) is a potentially reversible syndrome characterized by enlarged cerebral ventricles (ventriculomegaly), cognitive impairment, gait apraxia and urinary incontinence. A critical review of the concept, pathophysiology, diagnosis, and treatment of both idiopathic and secondary NPH was conducted. We searched Medline and PubMed databases from January 2012 to December 2018 using the keywords "normal-pressure hydrocephalus" / "idiopathic normal-pressure hydrocephalus" / "secondary normal-pressure hydrocephalus" / "NPH" / "ventriculoperitoneal shunt". Read More

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Diagnosis of Ventricular Shunt Infection in Children: A Systematic Review.

World Neurosurg 2019 Sep 14;129:34-44. Epub 2019 May 14.

Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA.

Background: No widely accepted gold standard for diagnosis of shunt infection exists, with definitions variable among clinicians and publications. This article summarizes the utility of commonly used diagnostic tools and provides a comprehensive review of optimal measures for diagnosis.

Methods: A query of PubMed was performed extracting articles related to shunt infection in children. Read More

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September 2019

Atypical spinal endodermal cyst presenting with contralateral C2 neuralgia and aseptic meningitis.

Radiol Case Rep 2019 May 27;14(5):561-564. Epub 2019 Feb 27.

Department of Neurological Surgery, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan.

A previously healthy 43-year-old man presented with durable occipitalgia for 1 month. Neurological examination revealed severe pain in the right C2 area accompanied by neck stiffness. Magnetic resonance imaging revealed an enhancing, polycystic intradural mass at the C2 level, occupying the left dorsolateral part of the spinal canal. Read More

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Slit Ventricle Syndrome Leads to 10-Year History of Repetitive Transient Central Herniation Masquerading as Seizures: Hydrocephalus Case Report.

World Neurosurg 2019 06 1;126:134-138. Epub 2019 Mar 1.

Department of Neurosurgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin, USA.

Background: Slit-ventricle syndrome (SVS) is a recognized complication of ventricular shunt malfunction, resulting in cyclical symptoms without ventricular dilatation. We present a case of SVS with transient, repetitive, and progressive signs of brainstem herniation evidenced by pupillary dilatation, posturing, and unresponsiveness, with diffuse voltage attenuation on electroencephalogram (EEG).

Case Description: A 32-year-old female presented with a history of hydrocephalus and ventriculoperitoneal shunt placement at 9 months of age. Read More

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Lumbar drain trial outcomes of normal pressure hydrocephalus: a single-center experience of 254 patients.

J Neurosurg 2019 01;132(1):306-312

1Department of Neurological Surgery.

Objective: A short-term lumbar drain (LD) trial is commonly used to assess the response of normal pressure hydrocephalus (NPH) patients to CSF diversion. However, it remains unknown whether the predictors of passing an LD trial match the predictors of improvement after ventriculoperitoneal shunting. The aim of this study was to examine outcomes, complication rates, and associations between predictors and outcomes after an LD trial in patients with NPH. Read More

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January 2019

The role of lumboperitoneal shunts in managing chronic hydrocephalus with slit ventricles.

J Neurosurg Pediatr 2018 Dec;22(6):632-637

1Departments of Neurosurgery and Pediatric Neurosurgery, Wayne State University School of Medicine and Children's Hospital of Michigan, Detroit; and.

OBJECTIVELumboperitoneal (LP) shunts have a role not only in pseudotumor cerebri, but also in patients with slit-like ventricles who are treated with CSF shunting on a chronic basis. Hesitation to utilize LP shunts is based on previous conventional beliefs including the tendency for overdrainage, difficulties accessing the shunt to tap or revise, and risk of progressive cerebellar tonsillar herniation. The authors hypothesized that the use of horizontal-vertical (HV) valves may reduce the risk of these complications, particularly overdrainage and development of Chiari malformation. Read More

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December 2018