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Journal of Neurosurgical Sciences 2002 June;46(2):100-3

Copyright © 2002 EDIZIONI MINERVA MEDICA

lingua: Inglese

Extremely rare complications in cerebrospinal fluid shunt operations

Surchev J., Georgiev K., Enchev Y., Avramov R.

Clinic of Pediatric Neurosurgery, Department of Neurosurgery, Medical University of Sofia, Sofia, Bulgaria


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The cere­bro­spi­nal ­fluid ­shunt oper­a­tion, ­from its ­first real­iza­tion in 1908 by Kausch ­till our ­days, is ­still of a sig­nif­i­cant impor­tance for the ­long-­term treat­ment of the inter­nal hydro­ceph­a­lus. Well ­known are ­many com­pli­ca­tions con­nect­ed ­with the use of the ­valve ­systems (mal­func­tion, infec­tious, over­drain­age, sec­on­dary cran­i­os­y­nos­to­sis and etc.). For a peri­od of 17 ­years (1984-2000) at the Clinic of Pediatric Neurosurgery, Department of Neurosurgery, Sofia Medical University, 414 cere­bro­spi­nal ­fluid ­shunt oper­a­tions ­were per­formed on chil­dren. 216 ­were ­drained to the ­right atri­um of the ­heart, 198 to the per­i­to­neal cav­ity. They ­were fol­lowed up by catam­ne­sis ­until the ­year 2001. The ­authors ­describe 2 extreme­ly ­rare cas­es ­with ­post-­shunt com­pli­ca­tion as a ­result of a mal­func­tion of the ­valve ­system, ­owing to a migra­tion of the dis­tal cath­e­ter: 1) in the ­anus; 2) in the ure­thra. In the ­first ­case the dis­tal cath­e­ter per­fo­rat­ed the ­colon trans­ver­sum and by the way of the intes­tines ­went out ­through the ­anus. In the sec­ond ­case the dis­tal cath­e­ter pro­trud­ed out of the ­body ­through the blad­der and the ure­thra. Their clin­i­cal appear­ance, the diag­nos­tic exam­ina­tions and the oper­a­tive treat­ment are ­shown.

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