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Cerebral spinal fluid overdrainage from shunt tap using large bore coring needle: A case report
Shiwei Huang1, Daniel Guillaume1
1Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota, United States.
Surgical Neurology International
|January 5, 2023
Summary
Percutaneous shunt taps using coring needles can damage ventriculoperitoneal shunts, leading to cerebrospinal fluid (CSF) leaks and overdrainage. Non-coring needles are recommended to prevent such complications.
Area of Science:
- Neurosurgery
- Biomedical Engineering
Background:
- Percutaneous access to ventriculoperitoneal (VP) shunts is common practice.
- Manufacturers recommend non-coring needles, but coring needles are frequently used.
Observation:
- A patient with hydrocephalus experienced CSF leaks attributed to prior shunt taps.
- An in vitro study demonstrated leaks from reservoirs tapped with coring needles.
- No leaks were observed when non-coring needles were used in the study.
Findings:
- Coring needles can cause significant damage to shunt reservoirs.
- This damage can lead to cerebrospinal fluid (CSF) leakage.
- Shunt reservoir damage may result in CSF overdrainage.
Implications:
- The use of coring needles for shunt access poses a risk of shunt malfunction.
- This practice may lead to complications such as intracranial hypotension.
- Adherence to manufacturer guidelines for needle selection is crucial for patient safety.
