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Resumen | Las alteraciones visuales de origen neurológico en los niños tienen diversas causas, algunas reversibles y otras no. La hidrocefalia es una de las más comunes e importantes, ya que puede producir deficiencias permanentes. Las causas de la hidrocefalia son variadas; entre las principales está la hemorragia intraventricular, generalmente debida al sangrado de la matriz germinal, el cual es muy común en recién nacidos prematuros. Se presenta el caso clínico de una paciente prematura con parálisis cerebral infantil, hemorragia intraventricular e hidrocefalia, producto de un embarazo múltiple, que presentó atrofia óptica en la infancia secundaria a la disfunción del sistema de derivación ventrículo-peritoneal. Durante su rehabilitación y tratamiento, ha recibido sesiones de neurorrehabilitación que le han permitido mejorar su agudeza y capacidad visual. Se comparó el caso de la paciente con algunos similares para establecer las semejanzas y las diferencias entre los cuadros clínicos presentados y la importancia del tipo de tratamiento médico utilizado en el curso de recuperación de la capacidad visual.
Abstract | Neurological visual impairments in children have multiple causes, some of them reversible while others are not. Hydrocephalus is one of the most important and common ones as it can result in permanent impairment. There are multiple causes of hydrocephalus, intraventricular hemorrhage being the main one. This generally occurs when the germinal matrix bleeds and is very common in preterm newborns. We present the clinical case of a patient with cerebral palsy, intraventricular hemorrhage, and hydrocephalus as a result of a preterm multiple pregnancy who developed optic atrophy during childhood secondary to ventricle-peritoneal shunt dysfunction. During the rehabilitation and treatment period, she received neurorehabilitation sessions, which improved her visual acuity and capacity. We found similarities and differences with other cases and we confirmed the importance of the treatment chosen for the recovery of visual capacity.
Subject(s)
Cerebral Palsy , Ventriculoperitoneal Shunt , Cerebral Hemorrhage , Optic Atrophy , Vision, Low , Neurological Rehabilitation , HydrocephalusABSTRACT
Objective To discuss the surgical method and efficacy of adult Dandy-Walker syndrome ( DWS) through retrospective anal-ysis and literature review .Methods There were 3 cases of adult DWS in our hospital from August 2010 to August 2011.One case of them was given posterior cranial fossa cyst peritoneal shunt , and the surgery adopted ordinary high voltage shunt .Case 2 was given left side of the lateral ventricle peritoneal shunt , and the surgery adopted ordinary high voltage shunt .Case 3 was given posterior cranial fossa cyst peritoneal shunt combined with left side of the lateral ventricle peritoneal shunt , and the surgery adopted double-end high voltage shunt .The two ends of the shunt were respectively linked with the diverter valve and abdominal cavity drainage tube through T -branch pipe .Results Among the 3 patients, there was 1 case failed to ease the headache symptoms , and it was relieved one month later .The preoperative symptoms of the oth-er 2 cases disappeared immediately after the surgery .During the 4 years of follow-up,preoperative symptoms of the 3 patients disappeared , and there was no positive signs .Conclusion For adult patients with symptomatic DWS ,shunt surgery can eliminate symptoms ,relieve the tension of the posterior fossa cyst ,achieve good curative effect , and there was no surgical complication .
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Objective To explore the impact of silver ions on the adhesion ability of Bacillus Calmette-Gueri vaccine on silicone tube surface. Methods Common and silver plated silicone tubes were cultured in BCG bacterial liquid for 30 days. A gas-bacilli was taken once every 3 days to measure OD value of microbial. The growth curve of BCG vaccine was made. The corresponding silicone tubes in divided different generations was removed and eluted based on the division cycle of BCG vaccine. The samples were inoculated on the solid medium for observing the colony growth amount, and adhesion curve was drawn. The silicone tube colony line was observed under the electron microscope at day 30. Results OD value and bacterial plaque number were less in silver silicone tube group than in common silicone tube group, with statistical significances (P < 0.05). Electron microscopy also showed that BCG adhesion on silver silicone tube group was relatively less than that on common silicone tube group. Conclusion Silver ions can reduce the adhesion of BCG vaccine on silicone tube surface and inhibit the growth of BCG vaccine.
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Las complicaciones abdominales de las derivaciones ventrículo peritoneales en la hidrocefalia, no son raras. Los pseudoquistes abdominales se reportan entre un 1- 4,5 por ciento y la mayoría de los pacientes necesitan cirugía. Se presenta un paciente masculino de 28 años de edad con antecedentes de hemorragia intraventricular del recién nacido e hidrocefalia secundaria a la misma. Múltiples infecciones y revisiones del sistema derivativo, la última hacía 14 años. Sintomatología de 6 meses de evolución caracterizada por crisis de llanto incontrolables asociadas a sudoración marcada, sin horario fijo y de varias horas de duración. Ultrasonografía abdominal muestra pseudoquiste abdominal suprahepático. Recibe tratamiento por técnica laparoscópica con liberación de catéter peritoneal, marsupialización del quiste y recolocación del catéter en otro cuadrante peritoneal. El pseudoquiste abdominal es una complicación infrecuente de las derivaciones ventrículo-peritoneales y debe sospecharse en pacientes con dolor abdominal. Una vez diagnosticado, el tratamiento de elección debe ser la laparoscopia(AU)
Abdominal complications of peritoneal shunts for hydrocephalus, are not uncommon. Abdominal pseudocysts are reported between 1- 4.5 percent and most patients need surgery. A male patient of 28 years old with a history of intraventricular hemorrhage and newborn secondary to hydrocephalus presents itself. Multiple infections and derivative system revisions, the last for 14 years. Symptoms 6 months of evolution characterized by uncontrollable crying spells associated with marked sweating, no fixed hours and several hours. Abdominal ultrasonography shows suprahepatic abdominal pseudocyst. Treated by laparoscopic technique with release of peritoneal catheter drainage of the cyst and repositioning of peritoneal catheter in another quadrant. The abdominal pseudocyst is a rare complication of ventricular-peritoneal shunts and should be suspected in patients with abdominal pain. Once diagnosed, the treatment of choice should be laparoscopy(AU)
Subject(s)
Humans , Male , Young Adult , Abdominal Abscess/surgery , Hydrocephalus/complications , Laparoscopy/methods , Ventriculoperitoneal Shunt/adverse effects , Abdominal Abscess/etiologyABSTRACT
Objective To investigate the related factors of infection post ventricle-peritoneal shunt and explore some preventive mea-sures. Methods 85 cases after ventricle-peritoneal shunt for normal pressure cranial hydrocephalus were analysed retrospectively. The effect of intensive prevention was observed. Results The overall infection rate was 7%after ventricle-peritoneal shunt. There was significant dif-ference between the patients with or without infection post-operation in some factors, such as preoperative infection (pneumonia, urinary tract infection, intracranial infection, biliary infection);the operator;activities of daily living. It was 9.8%(6/61) under routine aseptic opera-tion, and was 0 (0/24) under intensive management. Conclusion Infection after ventricle-peritoneal shunt is associated with many factors, es-pecially the susceptibility and contact to infection. Intensive management can significantly prevent the infection.
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Objective To investigate the effect of ventricle-peritoneal (V-P) shunt in treatment of patients who developed post-traumatic hydrocephalus (PTH) with no symptoms or with atypical symptoms due to an excessively severe traumatic brain injury (TBI).Methods A retrospective study was performed in patients who developed PTH with atypical symptoms undergone V-P shunt from January 2004 to June 2007.Patients' general information,TBI data,PTH severity and postoperative follow-up data were collected and applied to assay the improvement rate in prognosis and its associated factors.Results Thirty-one patients were involved in this study.After 12 months of follow-up,20 (65％) patients revealed significant improvements in clinical symptoms.Among 10 patients who developed PTH after decompressive craniectomy,cranioplasty was performed following V-P shunt and significant improvements were observed in nine patients.Patients' age and severity of PTH based on CT evaluation before shunt placement were strongly correlated with the surgical outcome.Conclusions Most PTH patients with atypical symptoms can benefit from V-P shunt.Additionally,younger patients and those with less severe PTH before V-P shunt are expected a better outcome.