Acute negative-pressure hydrocephalus: Management algorithm and value of early endoscopic ventriculostomy
| Autor: | Juan Casado Pellejero, Javier Orduna Martínez, David Rivero Celada, Jesús Moles Herbera, Silvia Vázquez Sufuentes, David Fustero de Miguel |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Ventriculostomy
medicine.medical_specialty medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine medicine Humans Retrospective Studies Third Ventricle business.industry Endoscopic third ventriculostomy Retrospective cohort study Low pressure hydrocephalus medicine.disease Endoscopic Procedure Surgery Hydrocephalus Treatment Outcome Neuroendoscopy Etiology business 030217 neurology & neurosurgery Shunt (electrical) Algorithms |
| Zdroj: | Neurocirugia (English Edition). |
| ISSN: | 2529-8496 |
| Popis: | Introduction Acute negative-pressure hydrocephalus is an uncommon, underrecognized patology with a high morbidity and mortality. We propose an algorithm to facilitate the management of these patients, promoting the early diagnosis and the use of endoscopic third ventriculostomy as initial therapeutic option. Methods We performed an observational retrospective study in which patients diagnosed with acute negative-pressure hydrocephalus were included. Patient age and symptoms, primary etiology of hydrocephalus, previous shunt, infection and surgical procedures, time from clinical deterioration to endoscopic procedure, definitive treatment and patient outcomes were recorded. Our management algortihm is exposed and justified. Results We identified five patients with diagnosis of acute negative-pressure hydrcephalus. In four of them the management algorithm was applied and early diagnosis and endoscopic ventriculostomy were performed. We observed complete succes of the endoscopic procedure in two patients (50%); the other two required permanent shunt, nevertheless resolution of the low-pressure state was achieved. One patient died after systemic infection (20%), 80% of the patients experienced good outcome. Conclusions The early identification of a negative-pressure hydrocephalic state is essential to reduce complications. Application of a specific management algortihm and early endoscopic third ventriculostomy could be advantageous to achieve better outcomes. |
| Databáze: | OpenAIRE |
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