Hemangioblastomatosis-associated negative-pressure hydrocephalus managed with improvised shunt.
Publication/Presentation Date
12-1-2018
Abstract
Low-pressure hydrocephalus (LPH) is a rare clinical diagnosis, characterized by neurologic decline and ventriculomegaly that persists despite normal to low intracranial pressure. LPH is typically managed by negative-pressure drainage via ventriculostomy, followed by low-resistance shunt insertion. We present the case of a middle-aged man with a history of hemangioblastomatosis who had spontaneous subarachnoid hemorrhage. He was treated with a ventriculoperitoneal shunt and then underwent resection of a Meckel's cave hemangioblastoma and whole brain irradiation. One month later, he presented to us with worsening symptoms and hydrocephalus despite shunt interrogations and revisions revealing no malfunction. Ventriculostomy drainage at negative-pressure was required for resolution of symptoms and ventriculomegaly, leading us to a diagnosis of LPH. This was successfully treated using an improvised ultra-low pressure valveless ventriculoperitoneal shunt, with maintained resolution of LPH for over one year. The system was created by ligating the distal slit valve end of a peritoneal catheter to prevent reflux and allow sub-zero pressure drainage by siphoning.
Volume
58
First Page
226
Last Page
228
ISSN
1532-2653
Published In/Presented At
Badran, A., Shepard, M. J., Ksendzovsky, A., Murayi, R., Hayes, C., Smart, D., & Chittiboina, P. (2018). Hemangioblastomatosis-associated negative-pressure hydrocephalus managed with improvised shunt. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 58, 226–228. https://doi.org/10.1016/j.jocn.2018.08.028
Disciplines
Medicine and Health Sciences
PubMedID
30287249
Department(s)
Department of Surgery
Document Type
Article