| The high risks of ventriculoperitoneal shunt procedures for hydrocephalus associated with vein of Galen malformations in childhood: case report and literature review. | |
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MedLine Citation:
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PMID: 20664304 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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Little to no pediatric or neurosurgical literature has been published about the complications of ventriculoperitoneal shunt procedures for hydrocephalus associated with vein of Galen malformations in childhood. The interventional neuroradiology literature, however, suggests that ventriculoperitoneal shunting as first-line treatment for hydrocephalus in children with vein of Galen malformations is fraught with short- and long-term dangers, including status epilepticus, intraventricular hemorrhage, subdural hematoma and hygroma, venous infarction, malignant dystrophic calcification, and worsening developmental delay. We present a single pediatric case where a ventriculoperitoneal shunt procedure for symptomatic hydrocephalus seemed to be the major contributing factor to the rapid neurological deterioration and eventual death of an infant with a vein of Galen malformation. Based on this experience and our review of the literature, we suggest the use of endovascular embolization of the vein of Galen malformation to reestablish a balance in hydrovenous dynamics as first-line treatment rather than directly addressing hydrocephalus with CSF diversion. The ventriculoperitoneal shunt procedure should be reserved for cases with symptomatic hydrocephalus in which the patient is a poor candidate for embolization, or for cases where endovascular therapy has already been maximized. The role of endoscopy in the treatment of hydrocephalus associated with vein of Galen malformations is not clear. |
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Authors:
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Andrew Jea; Tina J Bradshaw; William E Whitehead; Daniel J Curry; Robert C Dauser; Thomas G Luerssen |
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Publication Detail:
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Type: Case Reports; Journal Article; Review Date: 2010-07-28 |
Journal Detail:
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Title: Pediatric neurosurgery Volume: 46 ISSN: 1423-0305 ISO Abbreviation: Pediatr Neurosurg Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9114967 Medline TA: Pediatr Neurosurg Country: Switzerland |
Other Details:
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Languages: eng Pagination: 141-5 Citation Subset: IM |
Copyright Information:
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(c) 2010 S. Karger AG, Basel. |
Affiliation:
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Division of Pediatric Neurosurgery, Texas Children's Hospital, Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA. ajea @ bcm.edu |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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