التفاصيل البيبلوغرافية
| العنوان: |
Risk factors, treatment, and outcome in dogs and cats with subdural hematoma and hemispheric collapse after ventriculoperitoneal shunting of congenital internal hydrocephalus. |
| المؤلفون: |
Farke, Daniela, Siwicka, Anna K., Olszewska, Agnieszka, Czerwik, Adriana, Büttner, Kathrin, Schmidt, Martin J. |
| المصدر: |
Journal of Veterinary Internal Medicine; Nov/Dec2023, Vol. 37 Issue 6, p2269-2277, 9p |
| مصطلحات موضوعية: |
SUBDURAL hematoma, CEREBROSPINAL fluid shunts, SURGICAL decompression, HYDROCEPHALUS, PREOPERATIVE risk factors, DOGS |
| مستخلص: |
Background: Overshunting and hemispheric collapse are well‐known complications after ventriculoperitoneal shunt (VPS) implantation. Risk factors that predispose to overshunting, treatment options, and prognosis after therapeutic intervention have not been described. Hypothesis/Objectives: To identify preoperative risk factors for overshunting, the effect of surgical decompression, and their outcomes. Animals: Seventy‐five dogs and 7 cats. Methods: Retrospective case cohort study. Age, breed, sex, body weight, number of dilated ventricles, ventricle brain ratio, intraventricular pressure, and implanted pressure valve systems were evaluated as possible risk factors. Results: Overshunting had a prevalence of 18% (Cl 95% 9.9‐26.66). An increase of 0.05 in VBR increased the risk of overshunting by OR 2.23 (Cl 95% 1.4‐3.5; P =.001). Biventricular hydrocephalus had the highest risk for overshunting compared to a tri‐ (OR 2.48 with Cl 95% 0.5‐11.1) or tetraventricular hydrocephalus (OR 11.6 with Cl 95% 1.7‐81.1; P =.05). There was no influence regarding the use of gravitational vs differential pressure valves (P >.78). Overshunting resulted in hemispheric collapse, subdural hemorrhage, and peracute deterioration of neurological status in 15 animals. Subdural hematoma was removed in 8 dogs and 2 cats with prompt postoperative improvement of clinical signs. Conclusions and Clinical Importance: Biventricular hydrocephalus and increased VBR indicate a higher risk for overshunting. The use of differential valves with gravitational units has no influence on occurrence of overshunting related complications and outcomes. Decompressive surgery provides a favorable treatment option for hemispheric collapse and has a good outcome. [ABSTRACT FROM AUTHOR] |
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