Noninvasive intracranial pressure monitoring throughout brain compliance guiding a ventriculoperitoneal shunt replacement in hydrocephalus-case report.
Hydrocephalus
Intracranial pressure
Neurological Diagnostic Techniques
Point-of-care system
Slit ventricle syndrome
Ventriculoperitoneal shunt
Journal
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
ISSN: 1433-0350
Titre abrégé: Childs Nerv Syst
Pays: Germany
ID NLM: 8503227
Informations de publication
Date de publication:
08 2023
08 2023
Historique:
received:
03
08
2022
accepted:
12
03
2023
medline:
23
10
2023
pubmed:
29
3
2023
entrez:
28
3
2023
Statut:
ppublish
Résumé
Ventriculoperitoneal (VP) shunt is the primary therapy for hydrocephalus in children; however, this technique is amenable to malfunctions, which could be detected through an assessment of clinical signs and imaging results. Furthermore, early detection can prevent patient deterioration and guide clinical and surgical treatment. A 5-year-old female with a premedical history of neonatal IVH, secondary hydrocephalus, multiple VP shunts revisions, and slit ventricle syndrome was evaluated using a noninvasive intracranial pressure monitor device at the early stages of the clinical symptoms, evidencing increased intracranial pressure and poor brain compliance. Serial MRI images demonstrated a slight ventricular enlargement, leading to the use of a gravitational VP shunt, promoting progressive improvement. On the follow-up visits, we used the noninvasive ICP monitoring device to guide the shunt adjustments until symptom resolution. Furthermore, the patient has been asymptomatic for the past 3 years without requiring new shunt revisions. Slit ventricle syndrome and VP shunt dysfunctions are challenging diagnoses for the neurosurgeon. The noninvasive intracranial monitoring has allowed a closer follow-up assisting early assessment of brain compliance changes related to a patient's symptomatology. Furthermore, this technique has high sensitivity and specificity in detecting alterations in the intracranial pressure, serving as a guide for the adjustments of programmable VP shunts, which may improve the patient's quality of life. Noninvasive ICP monitoring may lead to a less invasive assessment of patients with slit ventricle syndrome and could be used as a guide for adjustments of programmable shunts.
Identifiants
pubmed: 36976418
doi: 10.1007/s00381-023-05922-3
pii: 10.1007/s00381-023-05922-3
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2215-2219Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Mazzola CA, Choudhri AF, Auguste KI, Limbrick DD, Rogido M Jr, Mitchell L, Flannery AM (2014) Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 2: Management of posthemorrhagic hydrocephalus in premature infants. J Neurosurg Pediatr 14(Suppl 1):8–23
Nag DS, Sahu S, Swain A, Kant S (2019) Intracranial pressure monitoring: gold standard and recent innovations. World J Clin Cases 7:1535–1553
doi: 10.12998/wjcc.v7.i13.1535
pubmed: 31367614
pmcid: 6658373
Roumeliotis N, Pettersen G, Crevier L, Émeriaud G (2015) ICP monitoring in children: why are we not adhering to guidelines? Childs Nerv Syst 31:2011–2014
doi: 10.1007/s00381-015-2837-9
pubmed: 26216060
Xu W, Gerety P, Aleman T, Swanson J, Taylor J (2016) Noninvasive methods of detecting increased intracranial pressure. Childs Nerv Syst 32:1371–1386
doi: 10.1007/s00381-016-3143-x
pubmed: 27351182
Jayanth A, Benabbas R, Chao J, Sinert R (2021) Diagnostic modalities to determine ventriculoperitoneal shunt malfunction: a systematic review and meta-analysis. Am J Emerg Med 39:180–189
doi: 10.1016/j.ajem.2020.09.024
pubmed: 33067062
Aralar A, Bird M, Graham R, Koo B, Chitnis P, Sikdar S, Shenai M (2018) Assessment of ventriculoperitoneal shunt function using ultrasound characterization of valve interface oscillation as a proxy. Cureus 10:e2205
pubmed: 29682435
pmcid: 5908717
Ballestero MFM, Frigieri G, Cabella BCT, de Oliveira SM, de Oliveira RS (2017) Prediction of intracranial hypertension through noninvasive intracranial pressure waveform analysis in pediatric hydrocephalus. Childs Nerv Syst 33:1517–1524
doi: 10.1007/s00381-017-3475-1
pubmed: 28623520
Auricchio AM, Bohnen A, Nichelatti M, Cenzato M, Talamonti G (2021) Management of slit ventricle syndrome: a single-center case series of 32 surgically treated patients. World Neurosurg
Paff M, Alexandru-Abrams D, Muhonen M, Loudon W (2018) Ventriculoperitoneal shunt complications: a review. Interdisciplinary Neurosurgery 13:66–70
doi: 10.1016/j.inat.2018.04.004
Hawryluk GWJ, Citerio G, Hutchinson P, Kolias A, Meyfroidt G, Robba C, Stocchetti N, Chesnut R (2022) Intracranial pressure: current perspectives on physiology and monitoring. Intensive Care Med 48:1471–1481
doi: 10.1007/s00134-022-06786-y
pubmed: 35816237
Rekate HL (2008) Shunt-related headaches: the slit ventricle syndromes. Childs Nerv Syst 24:423–430
doi: 10.1007/s00381-008-0579-7
pubmed: 18259760
Engel M, Carmel PW, Chutorian AM (1979) Increased intraventricular pressure without ventriculomegaly in children with shunts: “normal volume” hydrocephalus. Neurosurgery 5:549–552
doi: 10.1227/00006123-197911000-00001
pubmed: 534062
Kazimierska A, Kasprowicz M, Czosnyka M, Placek MM, Baledent O, Smielewski P, Czosnyka Z (2021) Compliance of the cerebrospinal space: comparison of three methods. Acta Neurochir (Wien) 163:1979–1989
doi: 10.1007/s00701-021-04834-y
pubmed: 33852065
Mascarenhas S, Vilela GH, Carlotti C, Damiano LE, Seluque W, Colli B, Tanaka K, Wang CC, Nonaka KO (2012) The new ICP minimally invasive method shows that the Monro-Kellie doctrine is not valid. Acta Neurochir Suppl 114:117–120
doi: 10.1007/978-3-7091-0956-4_21
pubmed: 22327675
Paraguassu G, Khilnani M, Rabelo NN, Cobos LD, Frigieri G (2021) Case report: untreatable headache in a child with ventriculoperitoneal shunt managed by use of new non-invasive intracranial pressure waveform. Front Neurosci 15:601945
doi: 10.3389/fnins.2021.601945
pubmed: 33679296
pmcid: 7928322
de AP Andrade R, Oshiro HE, Miyazaki CK, Hayashi CY, de Morais MA, Brunelli R, Carmo JP (2021) A nanometer resolution wearable wireless medical device for non invasive intracranial pressure monitoring. IEEE Sens J 21:22270–22284
doi: 10.1109/JSEN.2021.3090648