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Ventriculosternal Shunting for the Management of Hydrocephalus: Case Report of A Novel Technique.
- Source :
-
Neurosurgery [Neurosurgery] 2015 Sep; Vol. 11 Suppl 3, pp. 371-5; discussion 375. - Publication Year :
- 2015
-
Abstract
- Background: Conventional cerebrospinal fluid diversion such as ventriculoperitoneal or ventriculoatrial shunting for the management of hydrocephalus is one of the commonest neurosurgical procedures. However, in selected patients, surgical options are limited when relative contraindications for these operations exist. A patient who underwent ventriculosternal shunting, a novel procedure, is presented with durable and successful outcomes.<br />Objective: To demonstrate the feasibility, durability, and safety of ventriculosternal shunting for the management of hydrocephalus.<br />Methods: A patient with end-stage renal failure and heart failure with recurrent pleural effusion suffered from post-subarachnoid hemorrhage communicating hydrocephalus. Because of the need for continuous ambulatory peritoneal dialysis and the risk of introducing excessive cardiac preloading, conventional shunting was relatively contraindicated. Ventriculosternal shunting was performed by adopting the cancellous matrix of the sternum as the anatomic receptacle for intraosseous cerebrospinal fluid absorption. After placement of the ventricular catheter in the usual manner, the distal end was inserted into the sternum.<br />Results: There was demonstrable clinical and radiological improvement in hydrocephalus by ventriculosternal shunting. Cerebrospinal fluid intraosseous absorption by this novel procedure translated into both physical and cognitive recovery. The procedure was tolerable, effective, and durable, with the patient suffering no complications 3 years after the procedure.<br />Conclusion: Ventriculosternal shunting for the management of hydrocephalus is a feasible, safe, and durable surgical treatment option for selected patients when conventional procedures are contraindicated.
- Subjects :
- Cerebrospinal Fluid metabolism
Cognition
Diabetic Nephropathies complications
Endocarditis, Bacterial complications
Female
Heart Failure complications
Humans
Hydrocephalus psychology
Kidney Failure, Chronic complications
Middle Aged
Peritoneal Dialysis, Continuous Ambulatory
Postoperative Care
Subarachnoid Hemorrhage complications
Tomography, X-Ray Computed
Treatment Outcome
Cerebral Ventricles surgery
Cerebrospinal Fluid Shunts methods
Hydrocephalus surgery
Neurosurgical Procedures methods
Sternum surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4040
- Volume :
- 11 Suppl 3
- Database :
- MEDLINE
- Journal :
- Neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 26114598
- Full Text :
- https://doi.org/10.1227/NEU.0000000000000861