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Intraventricular Fluid Injection as a Novel Treatment of Subdural Fluid Collection after VP Shunt Overdrainage: A Case Report Budiwaluyo, Christian; Morota, Nobuhito; Yudhadi, Adhitya Rahadi; Yamamoto, Aya; Ihara, Satoshi; Tsuda, Kyoji
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 3 No. 1 (2021): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v3i1.5899

Abstract

Introduction: Subdural fluid collection is one of many complications of ventriculoperitoneal (VP) shunt. Variety of surgical procedures have been applied for the treatment of the post VP shunt subdural fluid collection, but the ideal surgical treatment remains controversial. Case Report: This is a case report of 14 years old boy who had a history of multiple VP shunt revisions for post hemorrhagic hydrocephalus with subdural fluid collections due to cerebrospinal fluid (CSF) overdrainage. Result: The author performed intraventricular fluid injection via shunt valve to expand the brain mantle and drain the subdural fluid through a small craniotomy. This is the first case report using the novel “fluid infusion” technique for the treatment of intractable subdural fluid collection after the VP shunt overdrainage. Conclusion: The technique can bring potentially great impact for the future treatment of symptomatic subdural fluid collection associated with CSF overdrainage after VP shunt.
The Role Of Ventriculoatrial Shunts For The Shunt Placement In Modern Medicine : A Case Report Yudhadi, Adhitya; Budiwaluyo, Christian; Morota, Nobuhito; Ihara, Satoshi; Tsuda, Kyoji
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 3 No. 1 (2021): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v3i1.5945

Abstract

Introduction: Although Ventriculoatrial (VA) shunt is one of the oldest solution for hydrocephalus, after the recognition of serious complication and operative difficulties, VA shunt procedure has fallen into disrepute. Since 1970s, most of neurosurgeons has changed their practice from VA shunt to ventriculoperitoneal (VP) shunt. It provides a prolong relief of intracranial pressure and easy to be performed. However, shunt revision may still be expected due to shunt infection, obstruction, migration and so on. When the peritoneum is precluded and no more available owing to the intra-abdominal adhesions, local sepsis and scarring from the previous surgery, VA shunt can be one of the choices to do the shunt revision. Whenever laparotomy for VP shunt has high possibility of serious complications and operative difficulties due to preexisting peritoneal compolication, VA shunt can be a safe and effective alternative in the neurosurgeon’s armamentarium for the cerebrospinal fluids (CSF) drainage. Case Report: In this case report, we described a case of premature 6-month-old baby boy with hydrocephalus, whose abdominal cavity had the previous history of peritonitis and stoma placement.   Result: Because his abdominal condition excluded placement of a distal catheter for VP shunt, VA shunt was planned as alternative procedure for VP shunt. Conclusion: Role of VA shunt in the era of modern neurosurgery is also discussed based on the literature review.