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  1. Article ; Online: Spontaneous Anal Extrusion of Ventriculoperitoneal Shunt Catheter

    Lívio Pereira de Macêdo / Arlindo Ugulino Netto / Kauê Franke / Pierre Vansant Oliveira Eugenio / Lucas Ribeiro de Moraes Freitas / Victor Ribeiro Xavier Costa / Eduardo Vieira de Carvalho Júnior / Igor Vilela Faquini / Nivaldo S. Almeida / Hildo Rocha Cirne Azevedo-Filho

    Brazilian Neurosurgery, Vol 41, Iss 04, Pp e382-e

    Case Report

    2022  Volume 385

    Abstract: Background Ventriculoperitoneal shunt (VPS) has become the standard treatment for congenital hydrocephalus. In the neurosurgical practice, it is a common procedure which usually results in low rates of complication. However, some serious complications ... ...

    Abstract Background Ventriculoperitoneal shunt (VPS) has become the standard treatment for congenital hydrocephalus. In the neurosurgical practice, it is a common procedure which usually results in low rates of complication. However, some serious complications can occur, including infections, intestinal perforation, and even death. Case Description A 19-year-old, female, asymptomatic patient, with a history of appendectomy and revision of the VPS 6 years before, presented spontaneous transanal extrusion of the catheter. Abdominal radiographs and tomography scans showed perforation of the descending colon without peritonitis, with expulsion of the distal tip of the catheter through the anus. The patient underwent removal of the proximal part of the VPS and installation of an external ventricular drain (EVD). On the second postoperative day, there was spontaneous elimination of the distal portion of the catheter, dispensing any additional surgical procedures. With antimicrobial prophylaxis and the contralateral VPS performed, the patient evolved without further complications until discharge. Diverging from cases reported in the literature, the patient in question did not present any abdominal manifestations. Conclusion Intestinal perforation by VPS may be asymptomatic until anal extrusion occurs. However, the early approach should avoid infections, which are associated with increased mortality. Removing only the proximal catheter, together with antimicrobial prophylaxis, can be an effective, safe and less invasive alternative to manage this complication of VPS.
    Keywords ventriculoperitoneal shunt ; intestinal perforation ; hydrocephalus ; Medicine ; R ; Surgery ; RD1-811
    Subject code 610
    Language English
    Publishing date 2022-12-01T00:00:00Z
    Publisher Thieme Revinter Publicações Ltda.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus

    Lívio Pereira de Macêdo / Arlindo Ugulino Netto / Kauê Franke / Pierre Vansant Oliveira Eugenio / John Anderson da Silva Rocha / Glaudir Donato Pinto Júnior / João Pedro Maia Medeiros / Juan Pablo Borges Rodrigues Maricevich / Nivaldo S. Almeida / Hildo Rocha Cirne Azevedo-Filho

    Brazilian Neurosurgery, Vol 40, Iss 04, Pp e297-e

    Case Series and Literature Review

    2021  Volume 302

    Abstract: Introduction The increase in intracranial pressure (ICP) is a neurological complication resulting from numerous pathologies that affect the brain and its compartments. Therefore, decompressive craniectomy (DC) is an alternative adopted to reduce ICP in ... ...

    Abstract Introduction The increase in intracranial pressure (ICP) is a neurological complication resulting from numerous pathologies that affect the brain and its compartments. Therefore, decompressive craniectomy (DC) is an alternative adopted to reduce ICP in emergencies, especially in cases refractory to clinical therapies, in favor of patient survival. However, DC is associated with several complications, including hydrocephalus (HC). The present study presents the results of an unusual intervention to this complication: the implantation of an external ventricular drain (EVD) in the intraoperative period of cranioplasty (CP). Methods Patients of both genders who presented with HC and externalization of the brain through the cranial vault after decompressive hemicraniectomy and underwent EVD implantation, to allow the CP procedure, in the same surgical procedure, were included. Results Five patients underwent DC due to a refractory increase in ICP, due to automobile accidents, firearm projectiles, falls from stairs, and ischemic strokes. All evolved with HC. There was no uniform time interval between DC and CP. The cerebrospinal fluid (CSF) was drained according to the need for correction of cerebral herniation in each patient, before undergoing cranioplasty. All patients progressed well, without neurological deficits in the immediate postoperative period. Conclusion There are still several uncertainties about the management of HC resulting from DC. In this context, other CP strategies simultaneous to the drainage of CSF, not necessarily related to ventriculoperitoneal shunt (VPS), should be considered and evaluated more deeply, in view of the verification of efficacy in procedures of this scope, such as the EVD addressed in this study.
    Keywords cranioplasty ; external ventricular drain ; post-traumatic hydrocephalus ; neurosurgery ; Medicine ; R ; Surgery ; RD1-811
    Subject code 616
    Language English
    Publishing date 2021-07-01T00:00:00Z
    Publisher Thieme Revinter Publicações Ltda.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Hepatic Liquoric Cyst as a Complication of Ventriculoperitoneal Shunt Insertion

    Lívio Pereira de Macêdo / Arlindo Ugulino Netto / Kauê Franke / Pierre Vansant Oliveira Eugenio / Lucas Ribeiro de Moraes Freitas / Davi Coutinho Marcelino Guerra Leone / Diego Pereira de Melo Oliveira / Eduardo Vieira de Carvalho Júnior / Igor Vilela Faquini / Nivaldo S. Almeida / Hildo Rocha Cirne Azevedo-Filho

    Brazilian Neurosurgery, Vol 40, Iss 04, Pp e408-e

    A Case Report

    2021  Volume 411

    Abstract: Background The ventriculoperitoneal shunt (VPS) procedure is still the most used technique for management of hydrocephalus. This article reports a case of hepatic cerebrospinal fluid (CSF) pseudocyst as a rare, but important, complication of the VPS ... ...

    Abstract Background The ventriculoperitoneal shunt (VPS) procedure is still the most used technique for management of hydrocephalus. This article reports a case of hepatic cerebrospinal fluid (CSF) pseudocyst as a rare, but important, complication of the VPS insertion. Case Description An 18-year-old male presented to the hospital complaining of temporal headache and visual turbidity for approximately 3 months with a history of VPS insertion for treatment of hydrocephalus and revision of the valve in adolescence. The diagnosis was based on abdominal imaging, demonstrating an extra-axial hepatic CSF pseudocyst free from infection. Following the diagnosis, the management of the case consisted in the removal and repositioning of the catheter on the opposite site of the peritoneum. Conclusion The hepatic CSF pseudocyst is an infrequent complication of VPS procedure, but it needs to be considered when performing the first evaluation of the patient. Several techniques are considered efficient for the management of this condition, the choice must be made based on the variables of each individual case.
    Keywords ventriculoperitoneal shunt ; cerebrospinal fluid pseudocyst ; hepatic cyst ; Medicine ; R ; Surgery ; RD1-811
    Language English
    Publishing date 2021-08-01T00:00:00Z
    Publisher Thieme Revinter Publicações Ltda.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Inter-library loan at ZB MED

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  4. Article ; Online: Paraplegia espástica causada por cisticercose intramedular

    Luciano Ferreira de Holanda / Benedito Jamilson Araújo Pereira / Rafael Rodrigues Holanda / Amauri Pereira da Silva Filho / José da Costa Leão Segundo / Pierre Vansant Oliveira Eugênio / Gabriela Nascimento Holanda

    Brazilian Neurosurgery, Vol 29, Iss 04, Pp 147-

    apresentação de caso e breve revisão bibliográfica

    2010  Volume 150

    Abstract: Relato de cisticercose intramedular em homem de 42 anos que há seis anos sentia parestesias em ambas as pernas, que evoluíram para ausência de sensação dolorosa, por fim paraparesia espástica dos membros inferiores. Ao exame físico, verificaram-se sinal ... ...

    Abstract Relato de cisticercose intramedular em homem de 42 anos que há seis anos sentia parestesias em ambas as pernas, que evoluíram para ausência de sensação dolorosa, por fim paraparesia espástica dos membros inferiores. Ao exame físico, verificaram-se sinal de Babinski bilateral, espasticidade dos membros inferiores e déficit de sensibilidade abaixo de T7. Ressonância nuclear magnética mostrou uma lesão expansiva ao nível de T5. Durante a exérese do processo, constatou-se que se tratava de cisticercose, em sua forma tumoral intramedular. Após a retirada, o mesmo evoluiu de maneira satisfatória, porém sem regressões dos sintomas.
    Keywords neurocisticercose intramedular ; Medicine ; R ; Surgery ; RD1-811
    Language English
    Publishing date 2010-12-01T00:00:00Z
    Publisher Thieme Revinter Publicações Ltda.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Inter-library loan at ZB MED

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  5. Article ; Online: Manobra de Valsalva como preditor do resultado da cirurgia de hérnia discal lombar

    Luciano Ferreira de Holanda / Rafael Rodrigues Holanda / Amauri Pereira da Silva Filho / José da Costa Leão Segundo / Benedito Jamilson Araújo Pereira / Pierre Vansant Oliveira Eugênio / Vanessa Milanesi de Holanda

    Brazilian Neurosurgery, Vol 29, Iss 03, Pp 91-

    2010  Volume 94

    Abstract: Objetivo: Demonstrar o valor da resposta dolorosa à realização da manobra de Valsalva na escolha do tratamento adequado da hérnia discal lombar. Casuística e método: Estudo prospectivo de 2.200 pacientes de ambos os gêneros, de diversas faixas etárias, ... ...

    Abstract Objetivo: Demonstrar o valor da resposta dolorosa à realização da manobra de Valsalva na escolha do tratamento adequado da hérnia discal lombar. Casuística e método: Estudo prospectivo de 2.200 pacientes de ambos os gêneros, de diversas faixas etárias, atendidos e acompanhados no Hospital Antônio Targino e na Clínica de Neurologia e Neurocirurgia Domício Holanda, na cidade de Campina Grande, PB, com diagnóstico de hérnia discal, no período de janeiro de 1993 a outubro de 2008. Os pacientes foram divididos em dois grupos: um grupo de 2.000 pacientes com lombociatalgia decorrentes de hérnias lombares que apresentavam dor durante a manobra de Valsalva e outro grupo de 200 pacientes que tinham as mesmas características clínicas do primeiro grupo, porém não apresentavam exacerbação da dor durante manobra de Valsalva. Resultado: Os 2.000 pacientes que apresentaram dor com a execução da manobra e foram submetidos à cirurgia tiveram boa resposta, enquanto os outros 200 pacientes que não referiram a mesma dor e que foram seguidos de maneira ambulatorial tiveram uma diminuição dessa dor, porém não precisaram de tratamento cirúrgico. Conclusão: A dor provocada pela manobra de Valsalva é sinal extremamente útil no que se refere à triagem desses pacientes.
    Keywords deslocamento do disco intervertebral lombar e manobra de valsalva ; Medicine ; R ; Surgery ; RD1-811
    Language English
    Publishing date 2010-09-01T00:00:00Z
    Publisher Thieme Revinter Publicações Ltda.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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