The value of multiple shunt systems in the treatment of nontumoral infantile hydrocephalus

Springer Science and Business Media LLC - Tập 2 - Trang 200-205 - 1986
G. Kaiser1
1Chirurgische Universitäts-Kinderklinik und Poliklinik, Inselspital, Bern, Switzerland

Tóm tắt

A multiple shunt system has been employed in nine children with hydrocephalus combined with absent or insufficient communication with intracranial-filled spaces. The common feature of the different lesions to such a shunt system is a pressure difference, which can be adjusted by this procedure. There arise four general indications: (1) the uniform drainage of CSF spaces which do not communicate with each other; (2) the uniform drainage of CSF and other separate liquid filled intracranial spaces; (3) to obtain gradual and steady diminution of enormously dilated CSF or other fluid-filled spaces; (4) the use of both sides for shunting in cases with recurrent failures of a unilateral drainage. The post-operative efficacy of a multiple shunt can be proved by demonstrating evenly decreasing CSF and other fluid-filled cavities, and by equilibrium between their different pressures. Evaluation of possible shunt failure in a multiple system requires CT and ICP recordings.

Tài liệu tham khảo

Choux M, Raybaud Ch, Pinsard N, Hassoun J, Gambarelli D (1978) Intracranial supratentorial cysts in children, excluding tumor and parasitic cysts. Child's Brain 4:15–32 Clar HE, Roosen C, Brenner A (1981) Long-term results after drainage of subdural effusions in infants. Z Kinderchir 34:164–166 Di Rocco C, Caldarelli M, Di Trapani G (1981) Infratentorial arachnoid cysts in children. Child's Brain 8:119–133 Foltz EL, DeFoe DR (1979) Isolated 4th ventricle (or double compartment) hydrocephalus: a new clinical entity. (7th Scientific Meeting of the International Society for Pediatric Neurosurgery, 1979.) Child's Brain 5:557 (abstr) Gerosa M, Di Stefano E, Carteri A, Villani R, Giovanelli M, Gaini SM (1977) Malformative pathology of the medial structures of the posterior fossa: considerations on 17 cases. (Modern problems in paediatrics, vol 18.) Karger, Basel, pp 128–136 Gruber R, Herzog B (1981) The therapy of the Dandy-Walker syndrome. Z Kinderchir 34:139–143 Hayashi T, Anegawa S, Honda E, Kuramoto S, Mori K, Murata T, Miwa S, Handa H (1979) Clinical analysis of arachnoid cysts in the middle fossa. Neurochirurgia (Stuttg) 22:201–210 Hoffmann HJ, Hendrick EB, Humphreys RP (1981) Suprasellar arachnoid cysts: investigation and management. (9th Scientific Meeting of the International Society for Pediatric Neurosurgery, 1981.) Child's Brain 8:238 (abstr) James HE, Kaiser G, Schut L, Bruce DA (1979) Problems of diagnosis and treatment in the Dandy-Walker syndrome. Child's Brain 5:24–30 Milhorat ThH (1978) Pediatric neurosurgery. (Contemporary neurology series.) Davis, Philadelphia Potthoff PC, Hemmer R (1970) The biventricular, the bilateral and the dualunilateral shunt. Dev Med Child Neuro [Suppl] 22:127–136 Raimondi AJ, Samuelson G, Yarzagaray L, Norton T (1969) Atresia of the foramina of Luschka and Magendie: the Dandy-Walker cyst. J Neurosurg 31:202–216 Raimondi AJ, Shimoji T, Gutierrez FA (1980) Suprasellar cysts: surgical treatment and results. Child's Brain 7:57–72 Salmon JH (1970) Isolated unilateral hydrocephalus following ventriculoatrial shunt. J Neurosurg 32:219–226 Sklar FH, Linder M, Diehl J (1981) Significance of postshunt ventricular asymmetries. (9th Scientific Meeting of the International Society for Pediatric Neurosurgery, 1981.) Child's Brain 8:221 (abstr) Sörensen N, Gaab M (1980) Supra- and infratentorial epidural pressure monitoring in Dandy-Walker syndrome. (8th Scientific Meeting of the International Society for Pediatric Neurosurgery, 1980.) Child's Brain 8:68 (abstr) Stevenaert A, Thibaut A (1977) Reconstitution of the cerebral mantle in shunted hydrocephalic children. (Modern problems in paediatrics, vol 18) Karger, Basel, pp 191–195 Suarez JC, Sfaello ZM, Albarenque M, Viano JC (1984) Porencephalic congenital cysts with hydrocephalus. Child's Brain 11:77–86 Udvarhelyi GB, Epstein MM (1975) The so-called Dandy-Walker syndrome; analysis of 12 operated cases. Child's Brain 1:158–162