63 results match your criteria Ventriculoperitoneal Shunt Tap


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

J Neurosurg Pediatr 2018 Sep 21:1-6. Epub 2018 Sep 21.

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

Objective: Lumboperitoneal (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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http://dx.doi.org/10.3171/2018.6.PEDS17642DOI Listing
September 2018
5 Reads
1.370 Impact Factor

Timed up and go test at tap test and shunt surgery in idiopathic normal pressure hydrocephalus.

Neurol Clin Pract 2017 Apr;7(2):98-108

Normal Pressure Hydrocephalus Center (SY, MI), Department of Neurosurgery, Rakuwakai Otowa Hospital, Kyoto; Department of Neurosurgery (MM, MN), Juntendo University Graduate School of Medicine, Tokyo; Department of Neurosurgery (MA), Atsuchi Neurosurgical Hospital, Kagoshima; Department of Neurosurgery (TK), Dohtoh Neurosurgical Hospital, Hokkaido; Department of Molecular Pathobiology of Brain Diseases (Neurology) (TT), Kyoto Prefectural University of Medicine; Department of Psychiatry (HK), Osaka University Graduate School of Medicine; and Department of Behavioral Neurology and Cognitive Neuroscience (EM), Tohoku University Graduate School of Medicine, Miyagi, Japan.

Background: The 3-meter Timed Up and Go test (TUG) is a reliable quantitative test for assessment of gait and balance. We aimed to establish an optimal threshold of TUG at the tap test for predicting outcomes 12 months after shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH).

Methods: The TUG was measured in a total of 151 patients with possible iNPH before and after a tap test and 12 months after shunt surgery. Read More

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http://dx.doi.org/10.1212/CPJ.0000000000000334DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5669413PMC
April 2017
8 Reads

Cognitive impairment predicts worse short-term response to spinal tap test in normal pressure hydrocephalus.

J Neurol Sci 2017 Aug 19;379:222-225. Epub 2017 Jun 19.

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

Introduction: In patients with idiopathic normal pressure hydrocephalus (iNPH), the spinal tap test (STT) is commonly used to predict ventriculoperitoneal shunt responsiveness. Clinical improvement following STT usually is measured by testing gait function. In our study, we investigated the impact of cognitive impairment on gait improvement after STT. Read More

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http://dx.doi.org/10.1016/j.jns.2017.06.028DOI Listing
August 2017
4 Reads

The Timed Up and Go Test as a Diagnostic Criterion in Normal Pressure Hydrocephalus.

World Neurosurg 2017 Sep 31;105:456-461. Epub 2017 May 31.

Cerebral Hydrodynamics Group, Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

Introduction: Normal-pressure hydrocephalus (NPH) is a disease characterized by gait disturbance, urinary incontinence, and dementia. Our objectives were to define an average value of the test for the population, check the specificity and test sensitivity as evaluation criteria and diagnostic testing, and correlate with other already used more frequently.

Methods: A study conducted at the Neurosurgery Division of the Hospital do Servidor Público Estadual de São Paulo in which a group of 30 patients with NPH was submitted to the Mini-Mental State Test Examination, Time Up and Go (TUG), test and Japanese scale for NPH before the Tap Test 3 hours and 72 hours after the Tap Test. Read More

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http://dx.doi.org/10.1016/j.wneu.2017.05.137DOI Listing
September 2017
28 Reads

A new quantitative method to assess disproportionately enlarged subarachnoid space (DESH) in patients with possible idiopathic normal pressure hydrocephalus: The SILVER index.

Clin Neurol Neurosurg 2017 Jul 19;158:27-32. Epub 2017 Apr 19.

Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), Pisa, Italy.

Objectives: Preoperative diagnosis of idiopathic normal-pressure hydrocephalus (iNPH) remains challenging. Recently, the presence of disproportionally enlarged subarachnoid spaces and hydrocephalus (DESH) on diagnostic images has been linked to clinical improvement after ventriculoperitoneal (VP) shunt placement. In this study we describe a new quantitative method to assess DESH on CT scans and to evaluate its prognostic value. Read More

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http://dx.doi.org/10.1016/j.clineuro.2017.04.015DOI Listing
July 2017
14 Reads

Supplementary Tests in Idiopathic Normal Pressure Hydrocephalus: A Single-Center Experience with a Combined Lumbar Infusion Test and Tap Test.

World Neurosurg 2017 Apr 9;100:567-574. Epub 2017 Jan 9.

Department of Pathophysiology and Organ Transplantation, University of Milan, Milan, Italy; Department of Neurosurgery, Ospedale Classificato "MoriggiaPelascini", Gravedona, Como, Italy.

Background: The lumbar infusion test (LIT) and tap test (TT) have previously been described for the diagnosis and selection of appropriate surgical candidates in idiopathic normal pressure hydrocephalus (iNPH).

Methods: We retrospectively reviewed 81 consecutive patients with a clinical diagnosis of iNPH selected for supplementary testing. Clinical evaluation was scored with the Japanese Grading Scale for Normal Pressure Hydrocephalus, the Global Deterioration Score, and the modified Rankin Scale (mRS). Read More

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http://dx.doi.org/10.1016/j.wneu.2017.01.003DOI Listing
April 2017
4 Reads

Investigation and clinical applications of muscle strength change in cerebrospinal fluid tap test in cases of idiopathic normal pressure hydrocephalus: A retrospective study.

J Neurol Sci 2016 Dec 11;371:18-23. Epub 2016 Oct 11.

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

The cerebrospinal fluid tap test (CSFTT) is widely used to diagnose idiopathic normal pressure hydrocephalus (iNPH) and predict the therapeutic effectiveness of shunting. However, the ability to walk cannot be quantified for patients who are unable to walk. Therefore, we examined whether the iNPH diagnostic aid is possible using dynamometry, even for patients who are unable to walk. Read More

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http://dx.doi.org/10.1016/j.jns.2016.10.009DOI Listing
December 2016
10 Reads

CSF tap test - Obsolete or appropriate test for predicting shunt responsiveness? A systemic review.

Authors:
Mario Mihalj

J Neurol Sci 2016 11 23;370:157. Epub 2016 Sep 23.

Department of Neurology, University Hospital Split, Spinčićeva 1, 21000 Split, Croatia.

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http://dx.doi.org/10.1016/j.jns.2016.09.045DOI Listing
November 2016
7 Reads
2.470 Impact Factor

Neonatal post-haemorrhagic hydrocephalus in the UK: a survey of current practice.

Br J Neurosurg 2017 Jun 30;31(3):307-311. Epub 2016 Sep 30.

b Department of Neurosurgery , King's College Hospital , Denmark Hill , London , UK.

Objectives: The management of neonatal post-haemorrhagic hydrocephalus (nPHH) varies considerably between centres and even between neurosurgeons in the same centre. We performed a nationwide survey to evaluate current practice in the UK and reviewed the evidence for each intervention.

Methods: An online semi-structured questionnaire was emailed to all units registered on the British Paediatric Neurosurgery Group Mailing List. Read More

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http://dx.doi.org/10.1080/02688697.2016.1226260DOI Listing
June 2017
19 Reads

[Long-term prognosis of idiopathic chronic adult hydrocephalus: I. The University Hospital Marqués de Valdecilla diagnostic and therapeutic protocol].

Neurocirugia (Astur) 2017 May - Jun;28(3):141-156. Epub 2016 May 31.

Servicio de Neurocirugía-Unidad de Raquis Quirúrgico, Servicio de Neurocirugía, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Cantabria; Instituto de Investigación Sanitaria Marqués de Valdecilla (IDIVAL), Santander, Cantabria; Observatorio de Salud Pública de Cantabria, Fundación Marqués de Valdecilla, Santander, Cantabria.

Introduction: Despite the existence of published guidelines for more than a decade, there is still a substantial variation in the management of idiopathic normal pressure hydrocephalus due to its diagnostic and therapeutic complexity.

Development: The diagnostic and therapeutic protocol for the management of idiopathic normal pressure hydrocephalus in use at the Department of Neurosurgery of the University Hospital Marqués de Valdecilla is presented. The diagnostic process includes neuropsychological testing, phase contrast cine MRI, urodynamic evaluation, continuous intracranial pressure monitoring, cerebrospinal fluid hydrodynamics by means of lumbar infusion testing, and intra-abdominal pressure measurement. Read More

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http://dx.doi.org/10.1016/j.neucir.2016.04.004DOI Listing
August 2018
21 Reads

Ventriculoperitoneal shunt malfunction caused by proximal catheter fat obstruction.

J Clin Neurosci 2016 Aug 20;30:120-123. Epub 2016 Apr 20.

Department of Neurosurgery, Hadassah-Hebrew University Medical Center, P.O. Box 12000, Jerusalem 91120, Israel.

Ventriculoperitoneal (VP) shunt placement is the mainstay of treatment for hydrocephalus, yet shunts remain vulnerable to a variety of complications. Although fat droplet migration into the subarachnoid space and cerebrospinal fluid pathways following craniotomy has been observed, a VP shunt obstruction with fat droplets has never been reported to our knowledge. We present the first reported case of VP shunt catheter obstruction by migratory fat droplets in a 55-year-old woman who underwent suboccipital craniotomy for removal of a metastatic tumor of the left medullocerebellar region, without fat harvesting. Read More

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http://dx.doi.org/10.1016/j.jocn.2015.11.029DOI Listing
August 2016
15 Reads

Normal Pressure Hydrocephalus and Parkinsonism: Preliminary Data on Neurosurgical and Neurological Treatment.

World Neurosurg 2016 Jun 10;90:348-356. Epub 2016 Mar 10.

Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.

Objective: Idiopathic normal pressure hydrocephalus (iNPH) may present, besides the classic triad of symptoms, with extrapyramidal parkinsonianlike movement disorders. We present a randomized prospective study comparing adjustable ventriculoperitoneal (VP) shunt insertion plus dopamine oral therapy (group A) versus VP shunt alone (group B) in patients affected by iNPH associated with parkinsonism.

Methods: A detailed screening process included neurologic, neurosurgical, and neuropsychological evaluations, followed by a cerebrospinal fluid tap test and resistance outflow measurement. Read More

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http://dx.doi.org/10.1016/j.wneu.2016.03.004DOI Listing
June 2016
33 Reads

Occam's razor in the management of ventriculoperitoneal shunt dysfunction: Diagnosis and management of an unusual pediatric case.

Asian J Neurosurg 2015 Apr-Jun;10(2):177-80

Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India.

Ventriculoperitoneal (VP) shunt surgery is probably the commonest surgical procedure in neurosurgery. Belying its technical simplicity is the myriad complications associated with it. Shunt malfunction is a common complication associated with this surgery, second only to shunt related infections, which may be associated with it. Read More

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http://dx.doi.org/10.4103/1793-5482.154988DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4421968PMC
May 2015
2 Reads

Instrumented gait analysis for an objective pre-/postassessment of tap test in normal pressure hydrocephalus.

Arch Phys Med Rehabil 2015 Jul 27;96(7):1235-41. Epub 2015 Feb 27.

Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy.

Objective: To present an objective method to evaluate gait improvements after a tap test in idiopathic normal pressure hydrocephalus (INPH).

Design: Retrospective analysis of gait data.

Setting: Public tertiary care center, day hospital. Read More

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http://dx.doi.org/10.1016/j.apmr.2015.02.014DOI Listing
July 2015
30 Reads

Case Report: A case report of dry tap during ventriculostomy.

F1000Res 2015 7;4:188. Epub 2015 Jul 7.

Department of Neurosurgery, College of Medical Sciences, Bharatpur, 44207, Nepal.

Pneumocephalus following ventriculoperitoneal (VP) shunt insertion is an exceptionally rare occurrence. We report such an event after attempting ventricular puncture (ventriculostomy) for VP shunt insertion and then discuss the management of the same. Dry tap can lead to multiple attempts for ventriculostomy with the associated added risks of complications, as well as complicating the subsequent management. Read More

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http://dx.doi.org/10.12688/f1000research.6750.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871012PMC
June 2016
4 Reads

What is the risk of infecting a cerebrospinal fluid-diverting shunt with percutaneous tapping?

J Neurosurg Pediatr 2014 Oct 8;14(4):336-9. Epub 2014 Aug 8.

School of Medicine, University of California, Irvine; and.

Object: Most CSF-diverting shunt systems have an access port that can be percutaneously tapped. Tapping the shunt can yield valuable information as to its function and whether an infection is present. The fear of causing a shunt infection by tapping may limit the physician's willingness to do so. Read More

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http://dx.doi.org/10.3171/2014.7.PEDS13612DOI Listing
October 2014
4 Reads

Ventriculoperitoneal shunt with a rare twist: small-bowel ischemia and necrosis secondary to knotting of peritoneal catheter.

J Neurosurg Pediatr 2014 Sep 4;14(3):234-7. Epub 2014 Jul 4.

Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois.

Small-bowel ischemia and necrosis due to knotting of the peritoneal catheter is an extremely rare complication related to a ventriculoperitoneal shunt (VPS). A 3-month-old girl, with a history of Chiari II malformation and myelomeningocele (MM) after undergoing right occipital VPS insertion and MM repair at birth, presented to the emergency department with a high-grade fever. Examination of a CSF sample obtained via shunt tap raised suspicion for the presence of infection. Read More

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http://dx.doi.org/10.3171/2014.6.PEDS1418DOI Listing
September 2014
15 Reads

External lumbar drain: A pragmatic test for prediction of shunt outcomes in idiopathic normal pressure hydrocephalus.

Surg Neurol Int 2014 27;5:12. Epub 2014 Jan 27.

Division of Neurosurgery, Department of Surgery, University of Toledo Medical Center, Toledo, Ohio, USA.

Background: The consensus on most reliable supplemental test to predict the shunt responsiveness in patients with idiopathic normal pressure hydrocephalus (iNPH) is lacking. The aim of this study is to discuss the utility of external lumbar drain (ELD) in evaluation of shunt responsiveness for iNPH patients.

Methods: A retrospective review of 66 patients with iNPH was conducted. Read More

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http://dx.doi.org/10.4103/2152-7806.125860DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3942611PMC
March 2014
3 Reads

Sonographic localization of a nonpalpable shunt: Ultrasound-assisted ventricular shunt tap.

Surg Neurol Int 2013 6;4:101. Epub 2013 Aug 6.

Department of Neurosurgery, Virginia Commonwealth University, Medical College of Virginia, Richmond, Virginia, USA.

Background: Patients frequently present to the emergency department (ED) for evaluation of cerebrospinal fluid (CSF) shunt malfunction, often requiring urgent management. A typical evaluation in the emergency room setting includes a thorough history and physical examination, noncontrasted head computed tomography (CT), shunt series, and occasionally a ventricular shunt tap.

Case Description: We present the case of a 53-year-old male who initially presented to the ED in acute status epilepticus. Read More

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http://dx.doi.org/10.4103/2152-7806.116151DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766327PMC
September 2013
2 Reads

Role of endoscopic third ventriculostomy and ventriculoperitoneal shunt in idiopathic normal pressure hydrocephalus: preliminary results of a randomized clinical trial.

Neurosurgery 2013 May;72(5):845-53; discussion 853-4

Division of Functional Neurosurgery of the Institute of Psychiatry, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil.

Background: Currently, the most common treatment for idiopathic normal pressure hydrocephalus (INPH) is a ventriculoperitoneal shunt (VPS), generally with programmable valve implantation. Endoscopic third ventriculostomy (ETV) is another treatment option, and it does not require prosthesis implantation.

Objective: To compare the functional neurological outcome in patients after 12 months of treatment with INPH by using 2 different techniques: ETV or VPS. Read More

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http://neurosurgery.med.wayne.edu/pdf/gr_-_etv_v_vps_for_nph
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http://pdfs.journals.lww.com/neurosurgery/2013/11000/Journal
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http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:land
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http://dx.doi.org/10.1227/NEU.0b013e318285b37cDOI Listing
May 2013
10 Reads

The European iNPH Multicentre Study on the predictive values of resistance to CSF outflow and the CSF Tap Test in patients with idiopathic normal pressure hydrocephalus.

J Neurol Neurosurg Psychiatry 2013 May 18;84(5):562-8. Epub 2012 Dec 18.

Hydrocephalus Research Unit, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg 413 45, Sweden.

Objective: The objective was to determine the sensitivity, specificity, and positive and negative predictive values of the CSF Tap Test (CSF TT) and resistance to CSF outflow (Rout) for the outcome of shunting in a sample of patients with idiopathic normal pressure hydrocephalus (iNPH).

Methods: 115 patients were included in this European multicentre study. Diagnosis was based on clinical symptoms and signs, and MRI changes. Read More

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http://dx.doi.org/10.1136/jnnp-2012-303314DOI Listing
May 2013
10 Reads

Normal pressure hydrocephalus in the spectrum of neurological complications of systemic lupus erythematosus.

Neurol Sci 2013 Jun 25;34(6):1009-13. Epub 2012 Jul 25.

Normal pressure hydrocephalus is an unusual manifestation of systemic lupus erythematosus and its pathogenesis is still unclear. We report the case of a 39-year-old white woman with systemic lupus erythematosus who developed magnetic gait, speech difficulties, progressive memory impairment, urinary incontinence and episodes of involuntary closure of the eyelids. Signs and symptoms, associated with ventriculomegaly and normal cerebrospinal fluid pressure, suggested normal pressure hydrocephalus, which as a complication of systemic lupus erythematosus believably develops due to the insidious inflammatory process that occurs in the meningeal tissues or to the vasculitis itself. Read More

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http://dx.doi.org/10.1007/s10072-012-1161-3DOI Listing
June 2013
7 Reads

Neuroimaging of ventriculoperitoneal shunt complications in children.

Pediatr Radiol 2012 Sep 28;42(9):1029-46. Epub 2012 Jun 28.

Baylor College of Medicine, Houston, TX, USA.

The ventriculoperitoneal shunt is the mainstay of treatment for hydrocephalus. Despite its widespread use and safety record, it often malfunctions due to complications such as obstruction, breakage, migration and infection. This necessitates a systematic approach to diagnosing the etiology of shunt failure. Read More

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http://link.springer.com/content/pdf/10.1007/s00247-012-2410
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http://link.springer.com/10.1007/s00247-012-2410-6
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http://dx.doi.org/10.1007/s00247-012-2410-6DOI Listing
September 2012
6 Reads

On the method of a randomised comparison of programmable valves with and without gravitational units: the SVASONA study.

Acta Neurochir Suppl 2012 ;114:243-6

Department of Neurosurgery, Unfallkrankenhaus, Berlin, Germany.

Objective: The supremacy of low-pressure valves (LPV) in the therapy of patients with idiopathic normal pressure hydrocephalus (iNPH) has been proven by the Dutch NPH study. The downside of LPVs is the high rate of overdrainage complications. In the meantime gravitational units have been developed with the objective of minimising overdrainage complications. Read More

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http://dx.doi.org/10.1007/978-3-7091-0956-4_48DOI Listing
May 2012
8 Reads

The value of the cerebrospinal fluid tap test for predicting shunt effectiveness in idiopathic normal pressure hydrocephalus.

Fluids Barriers CNS 2012 Jan 13;9(1). Epub 2012 Jan 13.

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

Background: The cerebrospinal fluid (CSF) tap test (TT) has been regarded as an important test for the prediction of shunt effectiveness in patients with suspected idiopathic normal pressure hydrocephalus (iNPH). Although its specificity and sensitivity are reportedly high, there remains some disagreement over this point. Herein, the TT as a test for predicting shunt effectiveness was investigated in our multicenter prospective study named SINPHONI and strategies to increase its predictability were examined. Read More

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http://dx.doi.org/10.1186/2045-8118-9-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3293050PMC
January 2012
3 Reads

Leucine-rich α-2-glycoprotein is a marker for idiopathic normal pressure hydrocephalus.

Acta Neurochir (Wien) 2011 Jun 19;153(6):1339-46; discussion 1346. Epub 2011 Feb 19.

Department of Neurosurgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan.

Objective: Cerebrospinal fluid (CSF) shunting can improve symptoms of elderly patients' idiopathic normal pressure hydrocephalus (iNPH). However, adjunctive means for confirming the diagnosis remain unavailable. We have previously reported the specific increase of leucine-rich alpha-2-glycoprotein (LRG) in iNPH CSF, and the present study investigates its potential clinical applications. Read More

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http://dx.doi.org/10.1007/s00701-011-0963-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3098968PMC
June 2011
9 Reads

Is it possible to minimize overdrainage complications with gravitational units in patients with idiopathic normal pressure hydrocephalus? Protocol of the randomized controlled SVASONA Trial (ISRCTN51046698).

Acta Neurochir Suppl 2010 ;106:113-5

Department of Neurosurgery, Unfallkrankenhaus Berlin, Berlin, Germany.

Overdrainage is a common complication observed after shunting patients with idiopathic normal-pressure hydrocephalus (iNPH), with an estimated incidence up to 25%. Gravitational units that counterbalance intracranial pressure changes were developed to overcome this problem. We will set out to investigate whether the combination of a programmable valve and a gravitational unit (proGAV, Aesculap/Miethke, Germany) is capable of reducing the incidence of overdrainage and improving patient-centered outcomes compared to a conventional programmable valve (Medos-Codman, Johnson & Johnson, Germany). Read More

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http://dx.doi.org/10.1007/978-3-211-98811-4_19DOI Listing
January 2010
4 Reads

Ventricular enlargement due to acute hypernatremia in a patient with a ventriculoperitoneal shunt.

J Neurosurg 2010 Jul;113(1):82-4

Department of Neurosurgery, Stanford University Medical Center, Stanford, California 94305, USA.

Patients requiring CSF shunts frequently have comorbidities that can influence water and electrolyte balances. The authors report on a case involving a ventriculoperitoneal shunt in a patient who underwent intravenous hyperhydration and withdrawal of vasopressin substitution prior to scheduled high-dose chemotherapy regimen for a metastatic suprasellar germinoma. After acute neurological deterioration, the patient underwent CT scanning that demonstrated ventriculomegaly. Read More

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http://dx.doi.org/10.3171/2009.10.JNS09845DOI Listing
July 2010
1 Read

[Lumboperitoneal shunt in an outpatient setting for the treatment of chronic hydrocephalus in adults. A study and follow-up of 30 cases].

Rev Neurol 2009 Sep 16-30;49(6):300-6

Servicio de Neurocirugía, Hospital General Universitario de Valencia, 46014 Valencia, Espana.

Introduction And Aims: One of the therapeutic options for chronic adult hydrocephalus that has become widely used in our service is the lumboperitoneal shunt with low-pressure Spetzler catheter and in an outpatient regimen. We report on the first 30 patients treated in this way with a follow-up of between one and five years.

Patients And Methods: Diagnosis was reached after studying the patient history and a clinical examination; Hakim and Adams' triad was found to be a primary and highly predictive factor, together with flow magnetic resonance imaging and the use of the ambulatory tap test. Read More

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February 2010
1 Read

[Idiopathic normal pressure hydrocephalus].

Praxis (Bern 1994) 2009 Aug;98(16):893-902

Klinik für Neurochirurgie, Kantonsspital St. Gallen, Rorschacher Strasse 95, St. Gallen.

Normal pressure hydrocephalus (NPH) is characterized by the classic triad of symptoms including gait disturbance, urinary incontinence, and dementia. Gait impairment represents the cardinal symptom. NPH is associated with a radiological verifiable ventriculomegaly in the absence of elevated cerebrospinal fluid (CSF) pressure. Read More

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http://dx.doi.org/10.1024/1661-8157.98.16.893DOI Listing
August 2009
2 Reads

Keeping CSF valve function with urokinase in children with intra-ventricular haemorrhage and CSF shunts.

Childs Nerv Syst 2009 Aug 18;25(8):981-6. Epub 2009 Apr 18.

Regional Service of Neurosurgery and Unit of Paediatric Neurosurgery, Virgen de la Arrixaca University Hospital, El Palmar E-30120, Murcia, Spain.

Background: Intra-ventricular haemorrhage (IVH) can occur spontaneously or during the surgical revision of ventricular cerebrospinal fluid (CSF) shunts.

Aim: The aim of the study was to report the safety and efficacy of an original method for treatment of IVH that may occur at the time of valve revision aimed at maintaining the function of previously implanted CSF shunts.

Patients And Methods: We reviewed the medical records of six patients who experienced an IVH in the presence of a previously placed ventriculoperitoneal (VP) shunt. Read More

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http://dx.doi.org/10.1007/s00381-009-0889-4DOI Listing
August 2009
4 Reads

Ventricular shunt tap as a predictor of proximal shunt malfunction in children: a prospective study.

J Neurosurg Pediatr 2008 Jun;1(6):439-43

Department of Neurological Surgery, University of Wisconsin-Madison, Madison, Wisconsin 53792-8660, USA.

Object: The clinical diagnosis of cerebrospinal fluid (CSF) shunt malfunction can be challenging. In this prospective study, the authors evaluated a common method of interrogating shunts: the shunt tap; specifically, its ability to predict proximal malfunction.

Methods: The authors performed standardized shunt taps in a consecutive series of cases involving children with suspected or proven shunt malfunction, assessing flow and, when possible, opening pressure. Read More

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http://dx.doi.org/10.3171/PED/2008/1/6/439DOI Listing
June 2008
7 Reads

Rethinking the indications for the ventriculoperitoneal shunt tap.

J Neurosurg Pediatr 2008 Jun;1(6):435-8

Department of Neurological Surgery, University Hospitals of Cleveland, Cleveland, Ohio 44106, USA.

Object: Tapping of a suspected malfunctioning ventriculoperitoneal shunt is usually easy, sometimes informative, but also potentially misleading. The purpose of this study was to determine the effectiveness of a shunt evaluation protocol that does not involve direct shunt tapping except in rare and specific cases.

Methods: The authors adopted a protocol for shunt evaluation that involves shunt tapping only in selected cases of suspected infection or in patients with noncommunicating hydrocephalus and equivocal computed tomography (CT) findings of shunt infection. Read More

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http://dx.doi.org/10.3171/PED/2008/1/6/435DOI Listing
June 2008
7 Reads

Ventriculoperitoneal shunt tap.

Authors:
W Jerry Oakes

J Neurosurg Pediatr 2008 Jun;1(6):433; author replies 433-4

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http://dx.doi.org/10.3171/PED/2008/1/6/433DOI Listing
June 2008
9 Reads

Continuous intracranial pressure monitoring via the shunt reservoir to assess suspected shunt malfunction in adults with hydrocephalus.

Neurosurg Focus 2007 Apr 15;22(4):E10. Epub 2007 Apr 15.

Department of Neurology and Neurosurgery, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.

Object: The authors attempted to determine whether continuous intracranial pressure monitoring via the shunt reservoir identifies ventriculoperitoneal (VP) shunt malfunctions that are not identified by radionuclide shunt patency study or shunt tap in adults with hydrocephalus.

Methods: During a 2-year period, 26 adults underwent 32 in-hospital continuous intracranial pressure (ICP) monitoring evaluations via needle access of a shunt reservoir. Monitoring was performed for 26. Read More

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April 2007
2 Reads

Predicting the outcome of shunt surgery in normal pressure hydrocephalus.

J Clin Neurosci 2007 Aug 12;14(8):729-36. Epub 2007 Jan 12.

Department of Neurosurgery, Haydarpasa Numune Education and Research Hospital, Uskudar, Istanbul, Turkey.

We studied retrospectively the effectiveness of the repeated lumbar CSF tap test (RTT), lumbar external CSF drainage (LED) and radioisotope cisternography (RIC) in predicting the outcome of shunt surgery, as well as the diagnostic and prognostic value of periventricular hyperintensity (PVH) and of the classic clinical triad in normal pressure hydrocephalus. Two hundred and seventy patients were referred to the Departments of Neurosurgery, in Nancy, France and in Istanbul, Turkey. The decision to perform surgery was based on the clinical presentation (all patients had at least two symptoms of the classic clinical triad), neuroimaging examinations and the results of the RTT (taps were performed on three consecutive days and at each tap a minimum of 30 to 40 cc of CSF was removed), the LED (drainage was performed for 3 days and the volume of CSF drained daily was a minimum of 150 to 250 cc) or the RIC. Read More

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http://dx.doi.org/10.1016/j.jocn.2006.03.028DOI Listing
August 2007
2 Reads

Multiple simultaneous intracerebral hemorrhages following accidental massive lumbar cerebrospinal fluid drainage: case report and literature review.

Neurol India 2006 Dec;54(4):421-4

Department of Neurology and Neurosurgery, Hospital Civil de Guadalajara Fray Antonio Alcalde, Mexico.

Multiple simultaneous intracerebral hemorrhages (ICH) are uncommon. We report the case of an 80-year-old woman with previous diagnosis of normal pressure hydrocephalus and who was brought to our hospital with altered mental status and urinary incontinence. Medical history of hypertension, hematological disorders or severe head trauma was absent. Read More

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December 2006
2 Reads

Seizure as a manifestation of intracranial hypotension in a shunted patient.

Pediatr Neurosurg 2006 ;42(3):165-7

Division of Pediatric Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, Canada.

The authors describe a child with a ventriculo-peritoneal shunt in place for 5 years who presented with 'postural' seizures (seizures on sitting upright, which resolved on recumbency). On shunt tap, the cerebrospinal fluid was obtained freely, but required gentle aspiration with a syringe in the recumbent position, suggesting very low intracranial pressure. Contrast magnetic resonance imaging showed pachymeningeal enhancement and enlargement of the pituitary gland diagnostic of intracranial hypotension along with well-decompressed ventricles. Read More

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http://dx.doi.org/10.1159/000091860DOI Listing
October 2006
2 Reads

Transient ventriculomegaly in a child presenting with hypernatremia. Case report.

J Neurosurg 2006 Mar;104(3 Suppl):192-4

Department of Neurosurgery, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, New York, USA.

The authors present the case of a 3-year-old girl with a history of myelomeningocele repair, ventriculoperitoneal (VP) shunt placement for hydrocephalus, and shaken baby syndrome who presented in a hypernatremic state as a result of dehydration. At the time of presentation, the patient had experienced a 1-week-long history of diarrhea associated with antibiotic agents used to treat a coexisting pyelonephritis. On admission, the patient exhibited signs and symptoms of dehydration and was discovered to have profound hypernatremia with a serum sodium level of 180 mmol/L. Read More

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http://dx.doi.org/10.3171/ped.2006.104.3.192DOI Listing
March 2006
1 Read

Polymerase chain reaction for the rapid detection of cerebrospinal fluid shunt or ventriculostomy infections.

Neurosurgery 2005 Dec;57(6):1237-43; discussion 1237-43

Division of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Objective: Infection after cerebrospinal fluid (CSF) shunts or ventriculostomies is a common complication associated with significant morbidity and mortality. Polymerase chain reaction (PCR) is a powerful molecular technique that allows rapid and precise amplification of bacterial deoxyribonucleic acid (DNA) and has proven a powerful tool in the detection of a wide variety of clinically important infectious diseases. We analyzed specimens of CSF derived from ventriculoperitoneal shunts or external ventricular drains by using both conventional cultures and PCR and report herein our preliminary results. Read More

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December 2005
12 Reads

[Pneumocephalus caused by failed ventricular tap: case report].

No Shinkei Geka 2005 Jun;33(6):607-10

Department of Neurological Surgery, Hiroshima City Hospital, Japan.

Objective And Importance: Ventricular tap is one of the most basic and important techniques to neurosurgeon. Brain tap itself usually does not cause symptomatic complication. The authors report an extremely rare complication case of pneumocephalus caused by failed ventricular tap. Read More

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June 2005
3 Reads

[Evaluation of lumbar tap test combined with mean cerebral blood flow measurement and electroencephalographic topography on idiopathic normal pressure hydrocephalus patients].

No Shinkei Geka 2004 Mar;32(3):247-55

Department of Neurosurgery Higashimatsuyama Municipal Hospital.

Purpose: To improve the diagnostic precision of the lumbar tap test (LTT).

Subjects And Methods: Thirty one patients (mean age, 65.4 years; male to female ratio, 12:19) suspected of having idiopathic normal pressure hydrocephalus (INPH) were used in the study. Read More

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March 2004
4 Reads

Predictors of outcome in patients with normal-pressure hydrocephalus.

Eur Neurol 2004 4;51(2):59-67. Epub 2003 Dec 4.

Department of Neurosurgery, Unfallkrankenhaus Berlin, Warener Strasse 7, DE-12683 Berlin, Germany.

Despite emerging knowledge of over 40 years, the postoperative results after shunt implantations in patients diagnosed for normal-pressure hydrocephalus (NPH) have not improved significantly in the last decade. For this reason, predictors have to be identified in order to preoperatively predict the course of disease. From 1982 to 2000, we examined in a prospective study 200 patients diagnosed for NPH. Read More

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http://dx.doi.org/10.1159/000075345DOI Listing
May 2004
2 Reads

Maternal postpartum group B beta-hemolytic streptococcus ventriculoperitoneal shunt infection.

Arch Gynecol Obstet 2004 Jan 11;269(2):139-41. Epub 2003 Jan 11.

Department of Pediatrics, Indiana University School of Medicine, 702 Barnhill Drive 1740X, Indianapolis, Indiana 46202-5225, USA.

Background: Women with cerebrospinal fluid shunts require special management during the course of pregnancy.

Case Report: We describe a case of delayed postpartum ventriculoperitoneal shunt infection by Group B streptococcus in a 19-year-old who presented complaining of headache and a fever. The CSF culture from the shunt tap and the distal shunt tip both grew Group B beta-hemolytic streptococcus. Read More

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http://dx.doi.org/10.1007/s00404-002-0464-7DOI Listing
January 2004
1 Read

[Shunt operation versus endoscopic ventriculostomy in normal pressure hydrocephalus: diagnostics and outcome].

Authors:
U Meier

Zentralbl Neurochir 2003 ;64(1):19-23

Klinik für Neurochirurgie, Unfallkrankenhaus Berlin.

In contrast to shunt operation the indication for an endoscopic ventriculostomy in patients diagnosed for normal pressure hydrocephalus is not scientifically established. From September 1997 to October 2001 we operated on 79 patients diagnosed for normal pressure hydrocephalus. Diagnosis was established by means of the intrathecal lumbal or ventricular infusion test, the cerebrospinal fluid tap test and MRI-CSF flow studies pre- and post-operatively. Read More

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http://dx.doi.org/10.1055/s-2003-37147DOI Listing
April 2003
2 Reads

Slit ventricle syndrome after cyst-peritoneal shunting for temporal arachnoid cyst in children--a clinical entity difficult to detect on neuroimaging study.

Brain Dev 2002 Dec;24(8):776-9

Division of Neurosurgery, Kawatetsu Chiba Hospital, Chiba, Japan.

Slit ventricle syndrome, known to occur from malfunction of the shunt procedure for hydrocephalus, is reported after cyst-peritoneal shunt for temporal arachnoid cyst. Two children aged 12 and 10 years, who underwent cyst-peritoneal shunting for a large temporal arachnoid cyst at the age of 10 and 5 years, respectively, recently experienced several episodes of severe headache. Prior to admission, repeated CT scans did not reveal any morphological change in either of these two patients. Read More

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December 2002
11 Reads

Comparison of ventriculoperitoneal shunt tap and lumbar puncture in a child with meningitis.

Pediatr Emerg Care 2002 Aug;18(4):E1-3

Department of Pediatrics, University of Connecticut School of Medicine, Connecticut Children's Medical Center, Hartford, Connecticut, USA.

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August 2002
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Clinical experiences with different valve systems in patients with normal-pressure hydrocephalus: evaluation of the Miethke dual-switch valve.

Childs Nerv Syst 2002 Jul 15;18(6-7):288-94. Epub 2002 May 15.

Department of Neurosurgery, Unfallkrankenhaus Berlin, Warener Strasse 7, 12683 Berlin, Germany.

Objective: In patients with normal-pressure hydrocephalus (NPH) and beginning brain atrophy the conventional differential pressure valve bears the disadvantage of opening abruptly when the patient moves into an upright position. In this way severe suction on the already atrophic brain could be induced. We wished to find whether this disadvantage, and especially the complication of the overdrainage, could be reduced or solved by a hydrostatic valve?

Methods: In 115 patients diagnosed with NPH we implanted 36 Cordis standard valves (CSV), 19 Cordis-Orbis-Sigma valves type I (OSV), and 60 Miethke Dual-Switch valves (M-DSV). Read More

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http://dx.doi.org/10.1007/s00381-002-0577-0DOI Listing
July 2002
3 Reads

The value of temporary external lumbar CSF drainage in predicting the outcome of shunting on normal pressure hydrocephalus.

J Neurol Neurosurg Psychiatry 2002 Apr;72(4):503-6

Department of Neurosurgery, Leiden University Medical Centre, Leiden, The Netherlands.

Objective: It has been reported that temporary external lumbar CSF drainage (ELD) is a very accurate test for predicting the outcome after ventricular shunting in patients with normal pressure hydrocephalus (NPH). However, only a limited number of patients have been studied for assessing the predictive accuracy of ELD. Therefore, the value of ELD in predicting the outcome after a ventriculoperitoneal shunt in patients with presumed NPH was assessed. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1737811PMC
April 2002
3 Reads

Endoscopic ventriculostomy versus shunt operation in normal pressure hydrocephalus: diagnostics and indication.

Acta Neurochir Suppl 2000 ;76:563-6

Department of Neurosurgery, Unfallkrankenhaus Berlin, Germany.

In contrast to shunt operation the indication for an endoscopic ventriculostomy in patients diagnosed for normal pressure hydrocephalus is not scientifically established. From September 1997 to March 1999 we operated on 36 patients diagnosed for normal pressure hydrocephalus. Diagnosis was established by means of the intrathecal lumbar or ventricular infusion test, the cerebrospinal fluid tap test and MRI-CSF flow studies pre- and post-operatively. Read More

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https://www.thieme-connect.com/products/ejournals/pdf/10.105
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August 2001
1 Read