Innovative approach to the difficult ventricular shunt using pleural access device for maintenance drainage: case report
Abstract
Patients with complex medical problems and multiple failed ventricular shunts require continued innovation for hydrocephalus management. The authors report the case of a 4-year-old boy with refractory hydrocephalus and secondary reduced ability to absorb CSF in both the pleural and peritoneal cavities following renal transplantation. A novel management approach was devised with split shunting to pleural and peritoneal targets as well as prophylactic pleural port placement to provide a method for minimally invasive thoracentesis should symptomatic pleural effusions develop. Fluid was successfully aspirated via the pleural port with relief of symptoms over a period of 16 months without complication. The authors demonstrate that a previously undescribed approach to distal shunting can prevent neurological sequelae of shunt failure and permit noninvasive maintenance drainage for patients in whom symptomatic pleural effusion is a recurrent complication.
Document Details
- Document Type
- Pub Defense Publication
- Publication Date
- Apr 01, 2020
- Source ID
- 10.3171/2019.10.peds19122
Entities
People
- Carolyn E. Gosztyla
- Howard I. Pryor
- Laurence Davidson
- Sharon R. Weeks
Organizations
- Uniformed Services University of the Health Sciences