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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Guideline for the management of long tunnelled external ventricular drains in chronic hydrocephalus
Phillip Correia Copley1, John Emelifeonwu1, Pasquale Gallo2
1Neurosurgery Registrar, Department of Paediatric Neurosurgery, Royal Hospital For Sick Children, Edinburgh.
Insights
This study details managing pediatric hydrocephalus in a child with an inoperable brain tumor using bilateral long-tunnelled external ventricular drains (LTEVDs). This innovative approach successfully managed the condition, improving the child's quality of life.
Area of Science:
- Pediatric Neurosurgery
- Neuro-oncology
- Medical Technology
Background:
- Hydrocephalus in children can be challenging, especially when caused by inoperable brain tumors like hypothalamic pilocytic astrocytoma.
- Standard treatments such as shunts may be refractory, necessitating alternative management strategies.
- Long-term management of pediatric hydrocephalus requires a multidisciplinary approach, including specialized nursing care and parental education.
Purpose of the Study:
- To describe the successful long-term management of hydrocephalus in a child with an inoperable hypothalamic pilocytic astrocytoma.
- To highlight the development and implementation of novel treatment protocols using bilateral long-tunnelled external ventricular drains (LTEVDs).
- To propose LTEVDs as a viable treatment option for pediatric hydrocephalus associated with inoperable tumors.
Main Methods:
- Utilized bilateral long-tunnelled external ventricular drains (LTEVDs) for long-term hydrocephalus management.
- Implemented multidisciplinary support, specialized nursing care, and comprehensive parental education.
- Developed and refined specific treatment protocols for managing LTEVDs in a community setting.
Main Results:
- Achieved successful long-term management of hydrocephalus in a pediatric patient with a complex brain tumor.
- Demonstrated the efficacy of LTEVDs in a challenging clinical scenario where shunts were ineffective.
- Established robust treatment protocols that facilitated the safe and effective use of LTEVDs.
Conclusions:
- Bilateral long-tunnelled external ventricular drains (LTEVDs) represent a viable and effective treatment option for pediatric hydrocephalus secondary to inoperable tumors.
- This approach can significantly improve the quality of life for children facing complex neurological conditions.
- Multidisciplinary collaboration and patient-specific protocols are crucial for successful long-term management.
Abstract:
This article reports on the journey of a child with an inoperable hypothalamic-origin pilocytic astrocytoma causing hydrocephalus, which was refractory to treatment with shunts, and required a new approach. With multidisciplinary support, excellent nursing care and parental education, the child's hydrocephalus was managed long term in the community with bilateral long-tunnelled external ventricular drains (LTEVDs). This article describes the patient's journey and highlights the treatment protocols that were created to achieve this feat. Despite the difficulties in initially setting up these protocols, they proved successful and thus the team managing the patient proposed that LTEVDs are a viable treatment option for children with hydrocephalus in the context of inoperable tumours to help maximise quality of life.
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