Hemangioblastomatosis-associated negative-pressure hydrocephalus managed with improvised shunt.
J Clin Neurosci
; 58: 226-228, 2018 Dec.
Article
em En
| MEDLINE
| ID: mdl-30287249
ABSTRACT
Low-pressure hydrocephalus (LPH) is a rare clinical diagnosis, characterized by neurologic decline and ventriculomegaly that persists despite normal to low intracranial pressure. LPH is typically managed by negative-pressure drainage via ventriculostomy, followed by low-resistance shunt insertion. We present the case of a middle-aged man with a history of hemangioblastomatosis who had spontaneous subarachnoid hemorrhage. He was treated with a ventriculoperitoneal shunt and then underwent resection of a Meckel's cave hemangioblastoma and whole brain irradiation. One month later, he presented to us with worsening symptoms and hydrocephalus despite shunt interrogations and revisions revealing no malfunction. Ventriculostomy drainage at negative-pressure was required for resolution of symptoms and ventriculomegaly, leading us to a diagnosis of LPH. This was successfully treated using an improvised ultra-low pressure valveless ventriculoperitoneal shunt, with maintained resolution of LPH for over one year. The system was created by ligating the distal slit valve end of a peritoneal catheter to prevent reflux and allow sub-zero pressure drainage by siphoning.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Cerebelares
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Derivação Ventriculoperitoneal
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Hemangioblastoma
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Hidrocefalia de Pressão Normal
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article