| Ventricular enlargement due to acute hypernatremia in a patient with a ventriculoperitoneal shunt. | |
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MedLine Citation:
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PMID: 19911884 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Patients requiring CSF shunts frequently have comorbidities that can influence water and electrolyte balances. The authors report on a case involving a ventriculoperitoneal shunt in a patient who underwent intravenous hyperhydration and withdrawal of vasopressin substitution prior to scheduled high-dose chemotherapy regimen for a metastatic suprasellar germinoma. After acute neurological deterioration, the patient underwent CT scanning that demonstrated ventriculomegaly. A shunt tap revealed no flow and negative opening pressure. Due to suspicion of proximal shunt malfunction, the comatose patient underwent immediate surgical exploration of the ventricle catheter, which was found to be patent. However, acute severe hypernatremia was diagnosed during the procedure. After correction of the electrolyte disturbances, the patient regained consciousness and made a good recovery. Although rare, the effects of acute severe hypernatremia on brain volume and ventricular size should be considered in the differential diagnosis of ventriculoperitoneal shunt failure. |
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Authors:
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Robert H Andres; Arjun V Pendharkar; Dominique Kuhlen; Luigi Mariani |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of neurosurgery Volume: 113 ISSN: 1933-0693 ISO Abbreviation: J. Neurosurg. Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-02 Completed Date: 2010-07-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0253357 Medline TA: J Neurosurg Country: United States |
Other Details:
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Languages: eng Pagination: 82-4 Citation Subset: AIM; IM |
Affiliation:
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Department of Neurosurgery, Stanford University Medical Center, Stanford, California 94305, USA. randres@stanford.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adult Antidiuretic Agents / administration & dosage, adverse effects* Antineoplastic Agents / administration & dosage Astrocytoma / complications, drug therapy, radiotherapy Brain Stem Neoplasms / complications, drug therapy, radiotherapy Cerebral Ventricles / pathology* Chemotherapy, Adjuvant Cranial Irradiation Deamino Arginine Vasopressin / administration & dosage, adverse effects* Diagnosis, Differential Diagnostic Errors Equipment Failure Analysis Fluid Therapy / adverse effects* Humans Hydrocephalus / etiology, surgery* Hypernatremia / complications*, diagnosis Hypertrophy Male Neoplasms, Multiple Primary / drug therapy, radiotherapy Pituitary Neoplasms / complications, drug therapy, radiotherapy Postoperative Complications / diagnosis, etiology*, surgery* Substance Withdrawal Syndrome / diagnosis, etiology* Tectum Mesencephali Tomography, X-Ray Computed* Ventriculoperitoneal Shunt* |
| Chemical | |
Reg. No./Substance:
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0/Antidiuretic Agents; 0/Antineoplastic Agents; 16679-58-6/Deamino Arginine Vasopressin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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