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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Low-pressure hydrocephalus: indication for custom-made catheters? Technical report.
L Galbarriatu1, M Rivero-Garvía, M Olivares
1Neurosurgery Department, Cruces University Hospital, Bilbao, Spain, lara.galbarriatugutierrez@osakidetza.net.
Acta Neurochirurgica
|August 2, 2013
Summary
Custom-made peritoneal catheters with larger inner diameters offer a promising solution for managing low-pressure hydrocephalus (LPH). This approach aids in sub-zero drainage, improving outcomes for patients with this complex neurological condition.
Area of Science:
- Neurosurgery
- Pediatric Neurosurgery
- Hydrocephalus Management
Background:
- Low-pressure hydrocephalus (LPH) presents with ventriculomegaly and low intracranial pressure (ICP).
- Effective management requires sub-zero drainage, with various treatment options available.
- This study explores custom-made peritoneal catheters as an alternative therapeutic strategy.
Purpose of the Study:
- To evaluate the efficacy of custom-made peritoneal catheters with larger inner diameters in managing low-pressure hydrocephalus.
- To report clinical experience with this novel catheter design in pediatric patients.
Main Methods:
- Retrospective review of pediatric patients with LPH treated with custom-made peritoneal catheters.
- Catheters were antibiotic or silver-coated, featuring a 1.4 mm inner diameter for ventricular catheters and a larger 1.9 mm inner diameter for peritoneal catheters.
- External ventricular drainage (EVD) was utilized for sub-zero drainage in all cases.
Main Results:
- Four patients received five custom-made peritoneal catheters over three years.
- Mean EVD duration was 102 days, with maximum negative pressure at -8 cm H2O.
- Post-implantation, patients received ventriculoperitoneal (VP) shunts with larger custom catheters; follow-up showed two complete recoveries, one partial dependence, and one mortality due to brain tumor.
Conclusions:
- Custom-made peritoneal catheters with increased inner diameter represent a viable option for managing complex low-pressure hydrocephalus.
- This approach may offer improved outcomes in specific pediatric neurosurgical cases.
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