[Clinical analysis of shunted hydrocephalic neonates and sucklings. Observation of postshunt complication due to overdrainage from intraventricular CSF].
During the past 3 decades hydrocephalus has been treated effectively with valve-regulated shunts and it would appear at present that this means of treatment will continue despite the fact that it probably has a higher complications rate than any other neurosurgical operation. The complications are generally categolized as those due to obstruction, those caused by infection, and those related to overdrainage. It appears, however, that the complications due to overdrainage such as the slit ventricle syndrome, the isolated unilateral lateral ventricle, and the isolated fourth ventricle and are poorly defined and understood and, therefore, the treatment has been subject of confusing literature. In this paper, the characteristics of neonatal and infantile hydrocephalus were discussed in an analysis of postoperative complications of cerebro-spinal fluid shunt procedures which focuses on the overdrainage by the shunt system. Ninety six cases of hydrocephalus which included 55 congenital and 41 acquired, were treated during a period of 7 years and 9 months. Patients with congenital hydrocephalus included 24 with myelomeningocele, 10 with encephalocele, and 21 with aqueductal stenosis associated with various cerebral anomalies. Patients with acquired hydrocephalus included 22 with posthemorrhagic and 19 with postmeningitic. There were 29 cases (30.2%) in which various complications due to overdrainage developed. In 12 of these additional conservative treatment and/or additional surgical therapies were necessary. Patients with complications included 19 (19.8%) with the slit ventricle, 6 with the unilateral isolated lateral ventricle, and 4 with the isolated fourth ventricle.(ABSTRACT TRUNCATED AT 250 WORDS)
Hayashi
T
T
Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan.
Hashimoto
T
T
Fukuda
S
S
Anegawa
S
S
Torigoe
R
R
D002552:Cerebral Ventricles / Q000473:pathology*; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery*; D007231:Infant, Newborn; D002532:Intracranial Aneurysm / Q000150:complications; D008591:Meningomyelocele / Q000150:complications; D010529:Peritoneal Cavity / Q000601:surgery; D011379:Prognosis; D013577:Syndrome