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Pericerebral collections after shunting.

E Hoppe-Hirsch, C Sainte Rose, D Renier

    Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
    |January 1, 1987
    PubMed
    Summary

    Pericerebral collections are a complication of pediatric hydrocephalus shunts, more common in older children and noncommunicating hydrocephalus. Treatment involves a simple shunt, with over 80% success.

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    Area of Science:

    • Neurosurgery
    • Pediatric Neurology
    • Medical Device Complications

    Background:

    • Hydrocephalus management in children often requires cerebrospinal fluid (CSF) shunting.
    • Shunt surgery can lead to complications, including pericerebral collections.
    • Understanding the incidence and risk factors for these collections is crucial for patient care.

    Purpose of the Study:

    • To investigate the incidence and characteristics of pericerebral collections following initial shunt insertions for pediatric hydrocephalus.
    • To identify risk factors associated with the development of these collections.
    • To evaluate the effectiveness of a specific treatment for post-shunt pericerebral collections.

    Main Methods:

    • Retrospective analysis of 682 initial shunt insertions for hydrocephalus in children (1976-1984).
    • Comparison of complication rates between initial insertions and reoperations.
    • Analysis of incidence based on patient age, hydrocephalus type, and shunt valve pressure.

    Main Results:

    • Nineteen pericerebral collections (18 subdural, 1 epidural) occurred in initial shunt insertions.
    • Incidence was higher in children over 2 years old (6.5%) versus younger children (1.7%).
    • Collections were more frequent in noncommunicating hydrocephalus and diagnosed within 2 months post-surgery.

    Conclusions:

    • Post-shunt pericerebral collections are a notable complication, particularly in older children with noncommunicating hydrocephalus.
    • CSF overdrainage is a likely cause, leading to pressure gradients that favor collection formation.
    • A simple peritoneal shunt insertion effectively treated over 80% of these collections.

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