Shunt Testing In Vivo: Illustration of Partially Obstructed Ventricular Catheter by In-Growing Choroid Plexus
| Autor: | Zofia Czosnyka, Richard Mannion, Virginia Levrini, Angelos G. Kolias, Indu Lawes |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Foramen magnum business.industry Decompression Neurosurgery General Engineering 030204 cardiovascular system & hematology medicine.disease cerebrospinal fluid Shunt (medical) Hydrocephalus Surgery 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid medicine.anatomical_structure ventriculoperitoneal shunt Medicine Choroid plexus chiari malformation hydrocephalus business 030217 neurology & neurosurgery Chiari malformation |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| DOI: | 10.7759/cureus.9287 |
| Popis: | Assessing shunt function in vivo presents a diagnostic challenge. Infusion studies can be a cost-effective and minimally invasive aid in the assessment of shunt function in vivo. We describe a case of a patient who after a foramen magnum decompression for type I Chiari malformation developed bilateral posterior fossa subdural hygromas and mild hydrocephalus, eventually necessitating insertion of a ventriculoperitoneal shunt. The patient returned with symptoms that were concerning for infection of the shunt. A bedside infusion study helped confirm that the ventricular catheter was partially obstructed by in-growing choroid plexus, but also that the shunt was no longer necessary. Partial blockage due to in-growing choroid plexus was confirmed during surgery to remove the shunt. We discuss the behaviour of in-growing choroid plexus and how partial obstruction can be detected with the use of an infusion study, as well as how this compares to the pattern observed in complete shunt obstruction. The benefits of using infusion studies in the assessment of shunt function are also explored. |
| Databáze: | OpenAIRE |
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