Turk Neurosurg
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Various complications following ventriculoperitoneal (VP) shunting have been reported but transoral protrusion of peritoneal catheter is a very rare situation. This case is the first adult with a transoral VP shunt protrusion in available literature. A 47-year-old female with pseudotumor cerebri admitted after the peritoneal catheter protruded from her mouth during retching. ⋯ Extrusion of peritoneal catheter through vagina, anus, scrotal skin or gastrostomy wound is well-known. However transoral protrusion should be considered as a very rare complication of VP shunting, especially in an adult. We present a rare case of transoral protrusion of a peritoneal catheter 10 years after ventriculo-peritoneal shunting procedure and review of the literature through this article.
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Conventional ventricular catheters have proven to be ineffective in the drainage of the cerebrospinal fluid in the long run in terms of infection rates. Consequently, the development and clinical evaluation of new catheters is urgently needed. ⋯ Our technique of a metal catheter implantation is safe and requires fewer reoperations. Moreover, it is cost-effective since metal catheters can be used for longer periods of time, can be reused in other patients, and are of low cost.
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Treatment options for traumatic brachial plexus injuries include nerve grafting, or neurotization. The type of lesion and the reconstructive procedures affect functional results and postoperative pain relief. ⋯ Early intervention for traumatic brachial plexus palsy is recommended to get good results with pain relief.
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Ventriculostomy or external ventricular drain (EVD) placement by free-hand technique has a high malplacement rate. It is a blind procedure that often requires multiple attempts and revisions. To date, no neurological complication due to EVD malplacement has been reported in the literature. ⋯ Our discussion focused on various techniques that can improve the accuracy of EVD insertion. EVD insertion under image guidance provides better accuracy with limited disadvantages. We hypothesized that the patient's coma was due to the mass effect and irritation of the malplaced EVD exerted onto the ventral periaqueductal grey matter and the ascending neurons from upper brainstem.
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The current study aims to explore the clinical characteristics of craniocerebral firearm injury and to improve the diagnosis and treatment of this condition. ⋯ Craniocerebral firearm injury is characterized by rapid traumatic condition development as well as serious trauma and contamination. Accurately judging the traumatic condition and the ballistic tract, performing complete debridement as early as possible, reasonably deciding on the operative mode and approach for intracranial residing foreign body removal, and increasing vigilance regarding concomitant injuries are the keys to the improvement of the overall treatment of craniocerebral firearm injury.