Overdrainage after ventriculoperitoneal shunting in a patient with a wide depressed skull bone defect: The effect of atmospheric pressure gradient
| العنوان: | Overdrainage after ventriculoperitoneal shunting in a patient with a wide depressed skull bone defect: The effect of atmospheric pressure gradient |
|---|---|
| المؤلفون: | Jinlu Yu, Yanwu Han, Guangming Wang, Lichao Sun, Lixiang Zhou |
| المصدر: | International Journal of Surgery Case Reports |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | musculoskeletal diseases, medicine.medical_specialty, Supine position, Traumatic brain injury, medicine.medical_treatment, 030209 endocrinology & metabolism, Case Report, Decompressive craniectomy, Bed rest, Cranioplasty, 03 medical and health sciences, 0302 clinical medicine, Cerebrospinal fluid, medicine, business.industry, medicine.disease, Ventriculoperitoneal shunt, Hydrocephalus, Surgery, Shunt (medical), Anesthesia, Atmospheric pressure, Overdrainage, business, 030217 neurology & neurosurgery |
| الوصف: | Highlights • Postoperative hydrocephalus is a frequent complication requiring cerebrospinal fluid (CSF) diversion. It is so complicated in the patient who had a wide decompressive craniectomy. • We herein emphasize the efficacy of VP shunting, supine bed rest and cranioplasty in treating hydrocephalus patients who have undergone craniectomy. • The gravitational effect and the atmospheric pressure gradient effect are two factors associated in the treatment of hydrocephalus for the patient who had decompressive craniectomy. These effects can be eliminated by supine bed rest and cranioplasty. Introduction In patients with traumatic brain injury, an effective approach for managing refractory intracranial hypertension is wide decompressive craniectomy. Postoperative hydrocephalus is a frequent complication requiring cerebrospinal fluid (CSF) diversion. Presentation of case A 50-year-old male who underwent decompressive craniectomy after traumatic brain injury. He developed hydrocephalus postoperatively, and accordingly we placed a ventriculoperitoneal shunt. However, an imbalance between the intra- and extra-cranial atmospheric pressures led to overdrainage, and he suffered cognitive disorders and extremity weakness. He remained supine for 5 days to avoid the effect of gravity on CSF diversion. After 20 days, we performed a cranioplasty using a titanium plate. The postoperative course was uneventful, and the patient achieved satisfactory recovery. Disccusion The gravitational effect and the atmospheric pressure gradient effect are two factors associated in the ventriculoperitoneal (VP) shunt treatment of hydrocephalus for the patient who had decompressive craniectomy. These effects can be eliminated by supine bed rest and cranioplasty. Conclusion We herein emphasize the efficacy of VP shunt, supine bed rest and cranioplasty in treating hydrocephalus patients who have undergone craniectomy. A flexible application of these procedures to change the gravitational effect and the atmospheric pressure gradient effect should promote a favorable outcome. |
| تدمد: | 2210-2612 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ca913fb6bc4de0222372494345d2e428Test https://pubmed.ncbi.nlm.nih.gov/27810603Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....ca913fb6bc4de0222372494345d2e428 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 22102612 |
|---|