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Related Experiment Videos

Negative-pressure hydrocephalus

M Vassilyadi1, J P Farmer, J L Montes

  • 1Department of Neurosurgery, Montreal Children's Hospital, Quebec, Canada.

Journal of Neurosurgery
|September 1, 1995
PubMed
Summary
This summary is machine-generated.

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Children with myelodysplasia and shunted hydrocephalus developed complications after spinal arachnoid cystopleural shunting. Revision of shunts resolved craniovertebral symptoms and ventricular dilation by correcting pressure gradients.

Area of Science:

  • Neurosurgery
  • Pediatric Neurology
  • Cerebrospinal Fluid Dynamics

Background:

  • Presents two pediatric cases with closed myelodysplasia, Arnold-Chiari malformation, and shunted hydrocephalus.
  • Focuses on complications following spinal arachnoid cystopleural shunting.

Observation:

  • Postoperative craniovertebral symptoms and ventricular dilation occurred despite functional ventriculoperitoneal (VP) shunts and negative intracranial pressure.
  • These symptoms resolved after revising the cystopleural shunts to increase flow resistance.

Findings:

  • Hypothesizes communication between the arachnoid cyst and subarachnoid space, leading to preferential transmission of negative pleural pressure.
  • Suggests the development of a transmantle pressure gradient causing ventricular dilation and a craniospinal gradient causing craniovertebral symptoms.

Related Experiment Videos

  • Demonstrates that correcting the iatrogenic transmantle pressure gradient restored VP shunt function.

    • Implications:

    • Highlights the potential for negative pleural pressure to affect intracranial dynamics in specific pediatric neurosurgical cases.
    • Underscores the importance of shunt resistance and pressure gradients in managing complex cerebrospinal fluid disorders.
    • Suggests careful consideration of shunt mechanics and potential pressure transmission in patients with combined spinal and intracranial abnormalities.