Top

Published in:

01-03-2021 | Hydrocephalus | Technical Notes

Low-pressure CSF shunt malfunction without preceding lumbar puncture treated by epidural blood patch: report of 2 cases

Authors: Adeline Kim, Doyle Lim, Joseph Piatt

Published in: Child's Nervous System | Issue 3/2021

Abstract

Low-pressure CSF shunt malfunction is a poorly understood complication of hydrocephalus affecting patients of all ages. Treatment commonly requires external drainage of CSF to subatmospheric pressures for days to weeks in an intensive care setting. The current communication describes the repurposing of an established therapeutic technique, epidural blood patch, for successful initial management in 2 cases of low-pressure shunt malfunction in the absence of a recognized spinal CSF fistula. This technique may shorten length of stay and obviate potential morbidity in the management of what is otherwise a vexatious clinical problem.

Dias MS, Li V, Pollina J (1999) Low-pressure shunt “malfunction” following lumbar puncture in children with shunted obstructive hydrocephalus. Pediatr Neurosurg 30:146–150. https://doi.org/10.1159/000028783

Foster KA, Deibert CP, Choi PA, Gardner PA, Tyler-Kabara EC, Engh JA (2016) Endoscopic third ventriculostomy as adjunctive therapy in the treatment of low-pressure hydrocephalus in adults. Surg Neurol Int 7:26. https://doi.org/10.4103/2152-7806.178522CrossRefPubMedPubMedCentral

Ghaleb A (2010) Postdural puncture headache. Anesthesiol Res Pract 2010. https://doi.org/10.1155/2010/102967

Keough MB, Isaacs AM, Urbaneja G, Dronyk J, Lapointe AP, Hamilton MG (2020) Acute low-pressure hydrocephalus: a case series and systematic review of 195 patients. J Neurosurg:1-9. https://doi.org/10.3171/2020.4.JNS20476

Pang D, Altschuler E (1994) Low-pressure hydrocephalic state and viscoelastic alterations in the brain. Neurosurgery 35:643–655. https://doi.org/10.1227/00006123-199410000-00010CrossRefPubMed

Rekate HL (2009) Acute ventriculoperitoneal shunt malfunction following opening of the spinal subarachnoid space. Childs Nerv Syst 25:1395–1396. https://doi.org/10.1007/s00381-009-0946-zCrossRefPubMed

Rekate HL (2019) Low or Negative Pressure Hydrocephalus Demystified. World Neurosurg 128:287–288. https://doi.org/10.1016/j.wneu.2019.05.032CrossRefPubMed

Rekate HL, Nadkarni TD, Wallace D (2008) The importance of the cortical subarachnoid space in understanding hydrocephalus. J Neurosurg Pediatr 2:1–11. https://doi.org/10.3171/PED/2008/2/7/001CrossRefPubMed

Smalley ZS, Venable GT, Einhaus S, Klimo P Jr (2017) Low-pressure Hydrocephalus in Children: A Case Series and Review of the Literature. Neurosurgery 80:439–447. https://doi.org/10.1093/neuros/nyw046CrossRefPubMed

10.

Vassilyadi M, Farmer JP, Montes JL (1995) Negative-pressure hydrocephalus. J Neurosurg 83:486–490. https://doi.org/10.3171/jns.1995.83.3.0486CrossRefPubMed

Title: Low-pressure CSF shunt malfunction without preceding lumbar puncture treated by epidural blood patch: report of 2 cases
Authors: Adeline Kim
Doyle Lim
Joseph Piatt
Publication date: 01-03-2021
Publisher: Springer Berlin Heidelberg
Keywords: Hydrocephalus
Hydrocephalus
Intracranial Hypertension
Hydrocephalus
CSF Drainage
Published in: Child's Nervous System / Issue 3/2021
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-020-04996-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Low-pressure CSF shunt malfunction without preceding lumbar puncture treated by epidural blood patch: report of 2 cases

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2021

A boy with a congenital cerebellar mass

Optic nerve sheath diameter does not correlate with intracranial pressure in pediatric neurocritical care patients

Flow ventricular catheters for shunted hydrocephalus: initial clinical results

White epidermoid: an important radiological mimic of the dermoid

The rationale and development of a CyberKnife© registry for pediatric patients with CNS lesions

A case of medulloblastoma in a patient with fetal ventricular enlargement