Innovative approach to the difficult ventricular shunt using pleural access device for maintenance drainage: Case report

Sharon R. Weeks, Carolyn E. Gosztyla, Laurence Davidson, Howard I. Pryor

Research output: Contribution to journalArticlepeer-review

Abstract

Patients with complex medical problems and multiple failed ventricular shunts require continued innovation for hydrocephalus management. The authors report the case of a 4-year-old boy with refractory hydrocephalus and secondary reduced ability to absorb CSF in both the pleural and peritoneal cavities following renal transplantation. A novel management approach was devised with split shunting to pleural and peritoneal targets as well as prophylactic pleural port placement to provide a method for minimally invasive thoracentesis should symptomatic pleural effusions develop. Fluid was successfully aspirated via the pleural port with relief of symptoms over a period of 16 months without complication. The authors demonstrate that a previously undescribed approach to distal shunting can prevent neurological sequelae of shunt failure and permit noninvasive maintenance drainage for patients in whom symptomatic pleural effusion is a recurrent complication.

Original languageEnglish (US)
Pages (from-to)407-410
Number of pages4
JournalJournal of Neurosurgery: Pediatrics
Volume25
Issue number4
DOIs
StatePublished - 2020
Externally publishedYes

Keywords

  • Hydrocephalus
  • Shunt Failure
  • Ventriculoperitoneal shunt
  • Ventriculopleural Shunt

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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