ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2009
Keeping CSF valve function with urokinase in children with intra-ventricular haemorrhage and CSF shunts.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 8 citations in OpenAlex.
- Shunt Malfunction Without Device Occlusion: A Case Report.Korean journal of neurotrauma · 2022Article
- Rapid Pore Cranial Drilling With External Ventricular Drainage for Treatment of Intraventricular Hemorrhage: A 36-Year Case Series.International surgery · 2015Article
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6 authors at 1 institution in 1 country.
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Abstract
backgroundIntra-ventricular haemorrhage (IVH) can occur spontaneously or during the surgical revision of ventricular cerebrospinal fluid (CSF) shunts.
aimThe aim of the study was to report the safety and efficacy of an original method for treatment of IVH that may occur at the time of valve revision aimed at maintaining the function of previously implanted CSF shunts. PATIENTS AND
methodsWe reviewed the medical records of six patients who experienced an IVH in the presence of a previously placed ventriculoperitoneal (VP) shunt. Five of the haemorrhages occurred during ventricular catheter replacement and the remaining one in a child given a VP shunt who sustained a spontaneous intra-cerebral haemorrhage. We inserted an external ventricular drainage without removing the original shunt. Urokinase was administered via the ventricular drain during several days until blood clearance in the CSF. Disappearance of the ventricular clots was checked by a cranial computerised tomography scan, while CSF shunt function was verified by the children's evolution and/or by a reservoir tap.
resultsFollow-up evaluation of the six patients demonstrated that the existing VP shunts were functioning appropriately and that the treatment was safe.
conclusionsPatients with IVH complicating ventricular catheter replacement and patients with spontaneous bleeding who harbour a VP shunt can be treated by intra-ventricular urokinase to avoid the removal of the initial shunt. The technique has proven to be safe and utilises the ventricular drain placed for the acute management of the IVH. Shunt replacement will always be possible in case of failure of the technique we are reporting.
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