Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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Review Case Reports
Ventriculoperitoneal shunt as a primary neurosurgical procedure in newborn posthemorrhagic hydrocephalus: report of a series of 47 shunted patients.
Intraventricular hemorrhage is the most common cause of infantile acquired hydrocephalus. Our objective is to determine if the implantation of ventriculoperitoneal shunt in posthemorrhagic hydrocephalus as a primary and definitive neurosurgical treatment, with no previous temporary procedures, would decrease complication rates with good functional outcomes. ⋯ Ventriculoperitoneal shunting as a primary neurosurgical treatment in posthemorrhagic hydrocephalus would decrease surgical morbidity with good functional outcome.
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The most common treatment for hydrocephalus remains the ventriculoperitoneal shunt. Yet, the most frequent complication is ventricular catheter obstruction, which may account for 50-80 % of newly inserted shunts. Although many factors contribute to this, the main one is related to flow characteristics of the catheter within the hydrocephalic brain. A landmark study by Lin et al. addressed the problem of fluid characteristics in ventricular catheters using a two-dimensional simulation program of computational fluid dynamics (CFD). ⋯ Most commercially available ventricular catheters have an abnormally increase flow distribution pattern. New catheter designs with variable hole diameters along the catheter tip will allow the fluid to enter the catheter more uniformly along its length, thereby reducing the probability of its becoming occluded.