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Intraparenchymal Pericatheter Cyst as a Complication of a Ventriculo-Peritoneal Shunt in a Premature Infant

  • Rim, Hae-Ri (Department of Pediatrics, Kyungpook National University Hospital) ;
  • Hwang, Sung-Kyoo (Department of Neurosurgery, Kyungpook National University Hospital) ;
  • Kwon, Soon-Hak (Department of Pediatrics, Kyungpook National University Hospital) ;
  • Kim, Heng-Mi (Department of Pediatrics, Kyungpook National University Hospital)
  • Received : 2010.09.28
  • Accepted : 2011.08.08
  • Published : 2011.08.28

Abstract

A ventriculo-peritoneal shunt is a standard surgical management for hydrocephalus, but complications may impede the management of this disease. Obstruction of the catheter is one of the most common complications and manifests clinically in various ways. Intraparenchymal cyst development after shunt malfunction has been reported by several authors, but the underlying mechanism and optimal treatment methods are debatable. The authors report a case of intraparenchymal cyst formation around a proximal catheter in a premature infant after a ventriculo-peritoneal shunt and discuss its pathogenesis and management.

Keywords

References

  1. Brenner DJ, Hall EJ : Computed tomography--an increasing source of radiation exposure. N Engl J Med 357 : 2277-2284, 2007 https://doi.org/10.1056/NEJMra072149
  2. Chiba Y, Takagi H, Nakajima F, Fujii S, Kitahara T, Yagishita S, et al. : Cerebrospinal fluid edema : a rare complication of shunt operations for hydrocephalus. Report of three cases. J Neurosurg 57 : 697-700, 1982 https://doi.org/10.3171/jns.1982.57.5.0697
  3. Hanigan WC, Morgan AM, Anderson RJ, Bradle P, Cohen HS, Cusack TJ, et al. : Incidence and neurodevelopmental outcome of periventricular hemorrhage and hydrocephalus in a regional population of very low birth weight infants. Neurosurgery 29 : 701-706, 1991 https://doi.org/10.1227/00006123-199111000-00010
  4. Heep A, Engelskirchen R, Holschneider A, Groneck P : Primary intervention for posthemorrhagic hydrocephalus in very low birthweight infants by ventriculostomy. Childs Nerv Syst 17 : 47-51, 2001 https://doi.org/10.1007/s003810000363
  5. Iqbal J, Hassounah M, Sheikh B : Intraparenchymal pericatheter cyst. A rare complication of ventriculoperitoneal shunt for hydrocephalus. Br J Neurosurg 14 : 255-258, 2000 https://doi.org/10.1080/026886900408487
  6. Kanal E, Barkovich AJ, Bell C, Borgstede JP, Bradley WG Jr, Froelich JW, et al. : ACR guidance document for safe MR practices : 2007. AJR Am J Roentgenol 188 : 1447-1474, 2007 https://doi.org/10.2214/AJR.06.1616
  7. Kazan S, Güra A, Uçar T, Korkmaz E, Ongun H, Akyuz M : Hydrocephalus after intraventricular hemorrhage in preterm and low-birth weight infants : analysis of associated risk factors for ventriculoperitoneal shunting. Surg Neurol 64 Suppl 2 : S77-S81; discussion S81, 2005 https://doi.org/10.1016/j.surneu.2005.07.035
  8. McCrea HJ, Ment LR : The diagnosis, management, and postnatal prevention of intraventricular hemorrhage in the preterm neonate. Clin Perinatol 35 : 777-792, vii, 2008 https://doi.org/10.1016/j.clp.2008.07.014
  9. Pierro A, Manalang LR, May PL, Cooke RW, Cudmore RE, Lloyd DA : Necrotizing enterocolitis complicating the management of posthemorrhagic hydrocephalus. J Pediatr Surg 28 : 982-985, 1993 https://doi.org/10.1016/0022-3468(93)90497-9
  10. Prasad A, Madan VS, Buxi TB, Renjen PN, Vohra R : The role of the perforated segment of the ventricular catheter in cerebrospinal fluid leakage into the brain. Br J Neurosurg 5 : 299-302, 1991 https://doi.org/10.3109/02688699109005190
  11. Prusseit J, Simon M, von der Brelie C, Heep A, Molitor E, Volz S, et al. : Epidemiology, prevention and management of ventriculoperitoneal shunt infections in children. Pediatr Neurosurg 45 : 325-336, 2009 https://doi.org/10.1159/000257520
  12. Rekate HL : Hydrocephalus in children in Winn HR (ed) : Youmans Neurological Surgery, ed 4. Philadelphia : Saunders, 2004, pp 3387-3417
  13. Sakamoto H, Fujitani K, Kitano S, Murata K, Hakuba A : Cerebrospinal fluid edema associated with shunt obstruction. J Neurosurg 81 : 179-183, 1994 https://doi.org/10.3171/jns.1994.81.2.0179
  14. Shin BC, Jung DK, Park JS, Kim YB, Min BK, Suk JS, et al. : A clinical analysis of ventriculoperitoneal shunt. J Korean Neurosurg Soc 18 : 431-438, 1989
  15. Sinha AK, Lall R, Benson R, O'Brien DF, Buxton N : Intraparenchymal pericatheter cyst following ventriculoperitoneal shunt insertion : does it always merit shunt revision? Zentralbl Neurochir 69 : 152-154; discussion 154, 2008 https://doi.org/10.1055/s-2007-992135
  16. Sugimoto K, Enomoto T, Nose T : Reversible porencephaly. Alteration of the cerebrospinal fluid flow after shunt malfunction. Childs Nerv Syst 7 : 394-398, 1991 https://doi.org/10.1007/BF00304205
  17. Udayasankar UK, Braithwaite K, Arvaniti M, Tudorascu D, Small WC, Little S, et al. : Low-dose nonenhanced head CT protocol for follow-up evaluation of children with ventriculoperitoneal shunt : reduction of radiation and effect on image quality. AJNR Am J Neuroradiol 29 : 802-806, 2008 https://doi.org/10.3174/ajnr.A0923
  18. Vajramani GV, Fugleholm K : Reversible CSF cyst related to a functioning ventriculo-peritoneal shunt. Acta Neurochir (Wien) 147 : 1199-1202; discussion 1202, 2005 https://doi.org/10.1007/s00701-005-0603-6
  19. Volpe JJ : Brain injury in the premature infant : overview of clinical aspects, neuropathology, and pathogenesis. Semin Pediatr Neurol 5 : 135-151, 1998 https://doi.org/10.1016/S1071-9091(98)80030-2
  20. Whitelaw A : Intraventricular haemorrhage and posthaemorrhagic hydrocephalus : pathogenesis, prevention and future interventions. Semin Neonatol 6 : 135-146, 2001 https://doi.org/10.1053/siny.2001.0047
  21. Willis BK, Kumar CR, Wylen EL, Nanda A : Ventriculosubgaleal shunts for posthemorrhagic hydrocephalus in premature infants. Pediatr Neurosurg 41 : 178-185, 2005 https://doi.org/10.1159/000086558
  22. Yu B, Li S, Lin Z, Zhang N : Treatment of posthemorrhagic hydrocephalus in premature infants with subcutaneous reservoir drainage. Pediatr Neurosurg 45 : 119-125, 2009 https://doi.org/10.1159/000209286

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