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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
14:59

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus

Published on: October 14, 2022

Role of ventriculoperitoneal shunt surgery in grade IV tubercular meningitis with hydrocephalus

Jing Peng1, Xiaolu Deng, Fang He

  • 1Department of Pediatrics, Xiangya Hospital, Central South University, Xiangya Road 87, Changsha, Hunan, People's Republic of China.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|September 13, 2011
PubMed

Insights

Ventriculoperitoneal shunt (VPS) placement in children with severe tuberculous meningitis and hydrocephalus (TBMH) shows clinical value. Direct VPS surgery may improve outcomes, with external ventricular drainage response not being a reliable predictor for shunt benefit.

Area of Science:

  • Pediatric Neurosurgery
  • Infectious Diseases
  • Neurology

Background:

  • Hydrocephalus is a frequent complication of tuberculous meningitis (TBM) in children.
  • The efficacy of ventriculoperitoneal shunt (VPS) placement in advanced (grade IV) TBM with hydrocephalus (TBMH) remains debated.

Purpose of the Study:

  • To evaluate the clinical utility of VPS placement for pediatric patients diagnosed with grade IV TBMH.
  • To assess the outcomes associated with VPS in this specific patient cohort.

Main Methods:

  • A cohort of 19 children with grade IV TBMH underwent VPS placement combined with medical treatment.
  • External ventricular drainage (EVD) was reserved for cases with severe metabolic disturbances or brainstem dysfunction requiring pre-surgical correction.
  • Patient outcomes were categorized as normal, mild sequelae, severe sequelae, death, or vegetative state.

Main Results:

  • Over a mean follow-up of 29 months, 3 patients died, 4 fully recovered, 8 had mild sequelae, and 4 experienced severe sequelae.
  • Six shunt-related complications were documented among the study participants.
  • The overall outcome suggests potential benefits from VPS intervention.

Conclusions:

  • Direct ventriculoperitoneal shunt surgery appears to enhance outcomes for children with grade IV TBMH.
  • Reliance on the response to external ventricular drainage is not a dependable method for identifying patients who would benefit from subsequent shunt surgery.
Abstract

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