ABSTRACT
OBJECTIVE: The authors report a case of racemose neurocysticercosis presented with myelopathy and hydrocephalus. The cllinical symtoms were not relieved even after the operations with albendazole medication. METHODS: A 44 year-old man was transferred due to headache, quadriparesis and epileptic fit. Preoperative magnetic resonance image(MRI) on brain and computed tomographic cisternogram on brain and upper cervical cord showed racemose cysticercosis on vermis, medulla and upper cervical cord. Two times operations(vesicles removal and adhesiolysis on cerebrospinal fluid pathway) were done with albendazole medication(15mg/kg/day, 30 days). The clinical symtoms were not relieved. Ventriculoperitoneal(V-P) shunt procedure was done and the symtoms were improved. CONCLUSION: The cause of aggravated hydrocephalus might be inflammatory reaction of the host to acute destruction of parasites due to albendazole in the brain.
Subject(s)
Adult , Humans , Albendazole , Brain , Cerebrospinal Fluid , Cysticercosis , Headache , Hydrocephalus , Neurocysticercosis , Parasites , Quadriplegia , Spinal Cord DiseasesABSTRACT
OBJECTIVE: To evaluate the advantages of Medos Hakim programmable valve system in the treatment of various type of hydrocephalus. MATERIALS AND METHODS: We retrospectively analyzed 33 patients who underwent ventriculoperitoneal shunt with Medos Hakim programmable valve system from December 1995 to June 1998. They were followed from 1 month to 35 months(mean 10.6 months). RESULTS: The overall outcome were excellent in 8 patients, improvement but residual symptoms in 16 patients and unchanged in 9 patients. There were 8 complications; overdrainage with subdural fluid collections(4 cases), infections(2 cases), obstruction(1 case) and mechanical failure(1 case). Overdrainage with subdural fluid collections was managed by readjustment of valve operating pressure alone in 3 cases and by observation in 1 case. Readjustment of valve pressure was needed more in children than in adults. There was significant correlation between opening and final pressure and the opening pressure was important for choosing the initial valve operating pressure at the time of implantation. CONCLUSION: In this study, we found that the Medos Hakim programmable valve is beneficial in cases with slowly progressive hydrocephalus and very large ventricles, especially in children, in order to normalize the ventricle size slowly with avoiding subdural hygromas.
Subject(s)
Adult , Child , Humans , Hydrocephalus , Retrospective Studies , Subdural Effusion , Ventriculoperitoneal ShuntABSTRACT
Variety of complications following ventriculoperitoneal(V-P) shunt have been reported. However, right ventricular migration of a V-P shunt has never been documented. The authors present a case of migrated peritoneal catheter of a V-P shunt system into the right venticle. To our knowledge, this is the first reported case complicated with migration of a peritoneal tube into the right ventricle. The patient was presented with fever and the migration was diagnosed by chest X-ray, and neck and cardiac ultrasonography.
Subject(s)
Humans , Catheters , Fever , Heart Ventricles , Neck , Thorax , UltrasonographyABSTRACT
Venticuloperitoneal shunt has been used in neurosurgery, for treatment of hydrocephalus, generally. The complications of Ventriculoperitoneal shunt are shunt obstruction, transrectal or intragastric extrusion, intestinal obstruction, bladder rupture, and catheter extrusion to umbilicus, scrotum or vagina. CSF hydrocele as a complication of migration or extrusion of the peritoneal end of Ventriculoperitoneal shunt has rarely been reported. Here a case of 3 year old bady, born at 38 week gestational age, is reported. The baby was noted to have painless, right scrotal swelling, one year after insertion of Ventriculoperitoneal shunt. The hydrocele of right side resolved fokkiwing herniorrhaphy of right side and revision of the shunt. Six months later, the baby presented with an enlarging left-sided scrotal swelling. Left side was also repaired.
Subject(s)
Child, Preschool , Humans , Catheters , Gestational Age , Herniorrhaphy , Hydrocephalus , Intestinal Obstruction , Neurosurgery , Rupture , Scrotum , Umbilicus , Urinary Bladder , Vagina , Ventriculoperitoneal ShuntABSTRACT
Since the discovery of CT scan for brain, the detection of hydrocephalus became easier than before. Of those hydrocephalus, non-parenchymatous in origin, in order words, normal pressure hydrocephalus can be differentiated by RISA cisternography. The etiology, symptomatology and surgical outcome of 16 cases of normal pressure hydrocephalus were presented. Followings are the results. 1) All of the cases revealed ventriculomegaly in brain CT scan and prolonged ventricular retention of dye in RISA cisternogram. 2) Ventriculoperitoneal shunt was done on all of the patients and outcome was excellent:3, good:6, fair:3 and poor:4. 3) It is thought that the prognosis is much related duration of clinical manifestation; the earlier surgery, the better outcome.
Subject(s)
Humans , Brain , Hydrocephalus , Hydrocephalus, Normal Pressure , Prognosis , Tomography, X-Ray Computed , Ventriculoperitoneal ShuntABSTRACT
Authors experienced fifteen cases of the pineal tumors during about 5 years from October, 1977 to September, 1982, which were diagnosed with brain C-T scanning. The details of clinical evaluation and follow up of 15 cases of the pineal tumors are presented. The following results were obtained. 1) The age group below age of 20 years in predominant and include 11 cases(73%) of 15 cases, and male is predominantly much than female. 2) On the neurological examination at admission, the RICP signs were showed in 15 cases, Parinaud's syndrome showed in 6 cases, cranial nerve palsy in 8 cases and DI symptom in 5 cases of all 15 cases. 3) In the follow up study, brain CT was more effective than any other conventional neuroradiologic technique. 4) 8 cases of all 15 cases have had normal life in follow up period with minium of 6 months and maximum of 6 months and maximum of 5 years, and one case with mild neurological deficit has been spent life for about 12 months. 5) Of 6 cases died within 2 years, 3 cases had insufficient treatment and 3 cases had sufficient treatment, of whom ond had tumor recurrence at primary site and dissemination to spinal epidural space and other two cases were suspected to have clinical dissemination to spinal cord. 6) On the basis of high survival rate in 9 cases of 12 cases who were treated completely, we thought that good survival rate in the patient with pinealoma will be resulted from a series of planed treatment, including early diagnosis, correction of hydrocepalus, surgical intervention and irradiation.
Subject(s)
Female , Humans , Male , Brain , Cranial Nerve Diseases , Early Diagnosis , Epidural Space , Follow-Up Studies , Germinoma , Immunotherapy , Neurologic Examination , Ocular Motility Disorders , Pinealoma , Recurrence , Spinal Cord , Survival RateABSTRACT
A 35-year-old male patient with hydrocephalus due to spontaneous subarachnoid hemorrhage secondary to brain tumor were treated with ventriculo-peritoneal shunt. Subsequently an unusual liver abscess developed at right lobe of liver which was drained successfully through the percutaneous puncture method. The liver abscess and ventriculitis was controlled with systemic, intrathecal and intraventricular antibiotics administrations. The authors have never seen a report of liver abscess after the ventriculoperitoneal shunt. The computed tomographic findings, managements of infection and a review of the literature is presented.
Subject(s)
Adult , Humans , Male , Anti-Bacterial Agents , Brain Neoplasms , Hydrocephalus , Klebsiella oxytoca , Liver Abscess , Liver , Punctures , Subarachnoid Hemorrhage , Ventriculoperitoneal ShuntABSTRACT
The first report of growing skull fractures of children was in 1861 by John How ship who noted partial absorption of the right parietal bone, arising from a blow on the head in a child aged 9 months. The cases of cranial defects that develope from fractures of the skull in childhood are not common but post-traumatic arachnoid cyst by delivery forceps had rarely reported in world literature. Consequently the author had a case of post-traumatic arachnoid cyst by delivery forceps with its common features and evaluated on various aspects of this syndrome. This case had been treated by surgery with removal of cyst, cranioplasty and V-P shunt.
Subject(s)
Child , Humans , Absorption , Arachnoid , Head , Hydrocephalus , Parietal Bone , Ships , Skull , Skull Fractures , Surgical InstrumentsABSTRACT
Cerebral cysticercosis is unfortunately a frequent disease in Korea. Cysticercosis in the ventricular system is most frequently found in the fourth ventricle. However it is found rarely in the lateral and third ventricle. Recently, we have encountered accidently a lateral ventricular cysticercosis during a V-P Shunt operation on a 32 year old hydrocephalus patient. The diagnosis was confirmed by the presence of an encysted larvae on aspiration.