Complications of ventriculoperitoneal shunts: Infection and exposure in hydrocephalus patients: A case series.

Surgical neurology international Pub Date : 2024-08-30 eCollection Date: 2024-01-01 DOI:10.25259/SNI_545_2024
Tommy Alfandy Nazwar, Sumarno Sumarno, Farhad Balafif, Donny Wisnu Wardhana, Ronald Aprianto Parubak, Melani Melani, Prima Putri Dyah Titisari, Christin Panjaitan, Indri Febriani
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Abstract

Background: Ventriculoperitoneal shunt (VPS) is an effective intervention for managing hydrocephalus; however, various complications may arise, one of which is infection due to shunt exposure. In this study, we report the incidence, risk factors, clinical presentation, and management strategies of four cases of shunt exposure in patients with hydrocephalus.

Case description: The first case involves a 1-year-10-month-old female who underwent her initial VPS placement at 7 months old due to hydrocephalus. The second case is a 3-month-old female who had a VPS placed at 20 days old for obstructive hydrocephalus and ventriculomegaly secondary to toxoplasmosis. The third case is a 15-year-old female who received a VPS due to a cerebral abscess with a prior history of tuberculous meningoencephalopathy. The fourth case is a 38-year-old male who underwent VPS placement for hydrocephalus. Two years post-intervention, the fourth patient was diagnosed with VPS exposure and subsequently underwent shunt removal.

Conclusion: The identification of risk factors and clinical symptoms in patients, supported by ancillary examinations such as cerebrospinal fluid analysis, can predict the incidence of VPS infections. Bacterial VPS infections can be managed with appropriate antibiotics tailored to the specific bacterial species. However, in certain cases, surgical removal of the VPS may be considered as a measure to eradicate infectious pathogens.

脑室腹腔分流术并发症:脑积水患者的感染和暴露:病例系列。
背景:脑室腹腔分流术(VPS)是治疗脑积水的一种有效干预措施;然而,可能会出现各种并发症,其中之一就是分流管暴露引起的感染。在本研究中,我们报告了四例脑积水患者分流管暴露的发生率、风险因素、临床表现和处理策略:第一个病例是一名 1 岁 10 个月大的女性患者,由于脑积水,她在 7 个月大时接受了首次 VPS 植入术。第二个病例是一名 3 个月大的女性,因弓形虫病继发梗阻性脑积水和脑室肥大,在出生 20 天时接受了 VPS 植入术。第三个病例是一名 15 岁女性,因脑脓肿接受了 VPS,之前曾有结核性脑膜脑病病史。第四个病例是一名 38 岁的男性,因脑积水接受了 VPS 植入术。干预两年后,第四位患者被诊断为 VPS 暴露,随后接受了分流管移除手术:结论:识别患者的危险因素和临床症状,并辅以脑脊液分析等辅助检查,可以预测 VPS 感染的发生率。细菌性 VPS 感染可使用针对特定细菌种类的适当抗生素进行治疗。但在某些情况下,可考虑通过手术切除 VPS,以根除感染性病原体。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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