ArticleJournal of neurosurgery. Case lessons2024
Bilateral vocal cord paralysis following ventriculoatrial shunt placement for hydrocephalus after subarachnoid hemorrhage: illustrative case.
Article in Journal of neurosurgery. Case lessons, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundA ventriculoatrial (VA) shunt is an alternative to a ventriculoperitoneal (VP) shunt for managing hydrocephalus, especially when VP shunt insertion is not feasible. Despite its decline in use, the VA shunt remains vital for certain patients. This report highlights a rare complication of bilateral vocal cord paralysis following VA shunt insertion for hydrocephalus secondary to subarachnoid hemorrhage. OBSERVATIONS: A woman in her 60s with a history of hypertension and giant liver cysts developed hydrocephalus after a subarachnoid hemorrhage. Because of her abdominal anatomical problems, VA shunt insertion assisted by transesophageal echocardiography (TEE) was chosen. Postoperatively, she experienced sudden dyspnea and upper airway stridor, diagnosed as bilateral vocal cord paralysis, necessitating an emergency tracheostomy. Gradual improvement was noted over the following month. LESSONS: Bilateral vocal cord paralysis can be a potential complication of TEE-assisted VA shunt procedures. To mitigate this risk, preoperative assessments of vocal cord function and swallowing are recommended. Alternatives to TEE, such as fluoroscopy or smaller probes, can be considered for patients with risk factors, including severe subarachnoid hemorrhage and prolonged intubation. https://thejns.org/doi/10.3171/CASE24518.
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