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July2010 Vol.47 Issue:        3       (Supp.) Table of Contents
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Endoscopic Procedures for Management of Ventriculo-Peritoneal Shunt Malfunction and Malposition: Preliminary Results in 12 Consecutive Cases

Hazem Mostafa Kamal

 

Department of Neurosurgery, Cairo University Hospitals; Egypt

 



ABSTRACT

Background: Shunt Malfunction is still a challenging problem for neurosurgeons despite the advances in shunt technologies and techniques. Objective: The aim of this study is to evaluate efficacy, safety, and possible complications of endoscopic intervention in treating shunt malfunction. Methods: Retrospective study of prospectively collected date of 12 consecutive patients between January 2006 and December 2008 presenting with V-P shunt malfunction. 7 patients (58%) were operated upon by Endoscopic Third Ventriculostomy (ETV), 3 patients (25%) had shunt malposition and the shunts were redirected under endoscopic guidance, and 2 patients (17%) had endoscopic lysis of catheter tip adhesions and ETV. Results: Clinically, all patients (100%) had marked improvement of symptoms during the first postoperative week. Radiologically, 7 patients (58%) had reduced ventricular size, 12 patients (100%) had restoration of lax subarachnoid space, and 3 patients with shunt tip malposition showed good postoperative tip site. Complications were encountered in 3 patients (25%), 2 of them had postoperative ventriculitis and were treated by shunt removal and External Ventricular Drain (EVD) placement, while the third patient presented with shunt malfunction 9 months postoperative and had resurgery (ETV). No procedure related complications were reported. Conclusion: Endoscopic procedures in experienced hands are safe and effective alternatives in treating V-P shunt malfunction and malposition with high success rate and few reported complications. [Egypt J Neurol Psychiat Neurosurg.  2010; 47(3): 367-371]

 

Key Words: shunt malfunction, third ventriculostomy, septostomy.

 

Correspondence to Hazem Mostafa Kamal, Department of Neurosurgery, Cairo University, Egypt.

Tel:+20122414488.  Email: zoomi73@hotmail.com





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